Chiari network

Chiari Network: Gross; fixed tissue, close-up of coronary sinus with fenestrae in valve
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

The Chiari network is a filamentous structure seen in the right atrium.

## Contents

* 1 History
* 2 Prevalence
* 3 Pathophysiology
* 4 Diagnosis
* 4.1 Echocardiography
* 4.2 Autopsy Findings
* 5 Additional Resources

## History

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The Chiari network was first described in 1897 in an autopsy series by Dr Chiari.

## Prevalence

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The Chiari network was noted to be present in 2-3% of the population. It was detected in approximately 1.5% of transthoracic echocardiographic studies in a series in 1984. Technical improvements in image quality may have increased the incidence of its detection.

## Pathophysiology

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The Chiari network is an embryological remnant of one of the valves of sinus venosus. This embryonic remnant has no known purpose and is not pathological. Although the Chiari network has no clinical significance, it must be distinguished from other pathological masses in the right atrium including thrombus, vegetation, and myxoma.

The Chiari network appears to be a web-like structure with a variable number of thread-like components.

Chiari network is characterized by whip-like motion within the right atrium and attachment to the wall of the right atrium in close proximity to the entrance of the inferior vena cava.

## Diagnosis

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Entrapment of catheters during right heart catheterization has been reported.

### Echocardiography

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### Autopsy Findings

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Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

* Chiari Network: Gross; fixed tissue, close-up of coronary sinus with fenestrae in valve

* Chiari Network: Gross; fixed tissue, close-up view, an excellent example

## Additional Resources

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* JA Werner, MD Cheitlin, BW Gross, SM Speck and TD Ivey. Echocardiographic appearance of the Chiari network: differentiation from right-heart pathology. Circulation 1981, Vol 63, 1104-1109,
* H. Tanaka, K. Ueda, M. Murakami, S. Hasegawa, and M. Sunamori A prominent Chiari network Ann. Thorac. Surg., June 1, 2002; 73(6): 1985 - 1985.
* D. M. Payne, R. J. F. Baskett, and G. M. Hirsch Infectious endocarditis of a Chiari network Ann. Thorac. Surg., October 1, 2003; 76(4): 1303 - 1305.
* H. Hara, R. Virmani, E. Ladich, S. Mackey-Bojack, J. Titus, M. Reisman, W. Gray, M. Nakamura, M. Mooney, A. Poulose, et al. Patent Foramen Ovale: Current Pathology, Pathophysiology, and Clinical Status J. Am. Coll. Cardiol., November 1, 2005; 46(9): 1768 - 1776.

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Congenital malformations and deformations of circulatory system (Q20-Q28, 745-747)

Cardiac chambers and connections|

Persistent truncus arteriosus \- Double outlet right ventricle (Taussig-Bing syndrome) - Transposition of the great vessels (dextro, levo)

Cardiac septa|

Ventricular septal defect \- Atrial septal defect (Lutembacher's syndrome) - Atrioventricular septal defect (Ostium primum) - Tetralogy of Fallot \- Eisenmenger's syndrome

Right: pulmonary and tricuspid valves|

pulmonary valves (stenosis, insufficiency) - tricuspid valves (stenosis, atresia) - Ebstein's anomaly

Left: aortic and mitral valves|

aortic valves (stenosis, insufficiency, bicuspid) - mitral valves (stenosis, regurgitation) - Hypoplastic left heart syndrome

Other congenital malformations
of heart|

Dextrocardia \- Levocardia \- Cor triatriatum

Great arteries|

aorta (Patent ductus arteriosus, Aortic coarctation, Interrupted aortic arch, Overriding aorta, Aneurysm of sinus of Valsalva, Vascular ring) - Pulmonary atresia

Great veins|

Persistent left superior vena cava \- Total anomalous pulmonary venous connection \- Scimitar syndrome

Other|

Arteriovenous malformation (Cerebral arteriovenous malformation)

See also non-congenital conditions (I, 390-459)

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