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Chiari network: a case report
Navindra Phuyal1, Niraj Pandey2, Ananda Kumar Mishra3
1Department of Anatomy, Rapti Academy of Health Sciences, Ghorahi, Dang, Nepal. itsmenavindra@gmail.com.
Insights
The Chiari network, a remnant of the sinus venosus, is found in about 2% of people. While often incidental, this cardiac anomaly can be linked to arrhythmias and interfere with medical procedures.
Area of Science:
- Cardiovascular Anatomy
- Embryological Remnants
Background:
- The Chiari network is a reticulated structure arising from the inferior vena cava valve.
- It occurs in approximately 2% of the general population.
Purpose of the Study:
- To describe a case of Chiari network identified during routine dissection.
- To review the clinical significance and diagnostic methods for the Chiari network.
Main Methods:
- Routine anatomical dissection of a cardiac specimen.
- Identification and description of the Chiari network's anatomical features.
- Review of literature regarding clinical associations and diagnosis.
Main Results:
- A fenestrated Chiari network was observed, attached to the inferior vena cava valve and crista terminalis.
- The network is associated with potential cardiac events like arrhythmias and guide wire entrapment.
- It may also prevent pulmonary embolism by entrapping thrombi.
- Transesophageal echocardiography is the preferred diagnostic method.
Conclusions:
- The Chiari network is an embryological remnant of the sinus venosus.
- It is typically found incidentally during echocardiography, dissection, or autopsy.
- This cardiac anomaly may be associated with various pathologies.
Background:
The Chiari network is a reticulated network originating from the inferior vena cava valve. Its incidence is observed to be about 2% in the general population.
Case Presentation:
In our instance, in a specimen observed during routine dissection, a fenestrated network of fibrous threads was attached to the inferior vena cava valve and the crista terminalis, sparing the coronary sinus valve and was identified as the Chiari network. Although clinically insignificant, the Chiari network is associated with various cardiac events including bundle branch blocks and ventricular and atrial arrythmias. It is also observed that the Chiari network is involved in the entrapment of guide wires inserted for interventions like cardiac catheterization and radiofrequency ablation procedure. Contrary to that, it is found to cause entrapment of thrombus preventing catastrophic massive pulmonary embolism. Transoesophageal echocardiography is considered as the best method to diagnose Chiari network.
Conclusions:
Chiari network is remnant of the sinus venosus which is usually found incidentally during echocardiography or dissections or during autopsy procedures. It may be associated with various cardiac pathologies.
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