Three-dimensional echocardiographic assessment of Chiari's network relationship with the left ventricular false tendon.

Background: Left ventricular false tendon (LVFT) is a fibromuscular band crossing the left ventricular cavity. And Chiari's network (CN) is a highly mobile, mesh-like, echogenic structure in right atrium. In this study, we aimed to evaluate the coexistence of LVFT in patients with CN. CN patients were examined with live/real-time three-dimensional transthoracic echocardiography (TTE) for visualization of LVFT.

Results: This is a single-center prospective study of 49 patients with CN. In literature studies, the average ratios of LVFT were 22% in the normal population. In our study, an increased ratio of LVFT (n = 31, 63.3%) was found in CN patients evaluated with a three-dimensional TTE (63.3% versus 22%) (p = 0.01). The interatrial septal aneurysm was found in 31 (63.3%) patients with CN. And, the positive contrast echocardiography examination was determined in 22 (61.1%) patients with CN.

Conclusions: Our study reveals that CN is associated with LVFT and is also associated with cardiac anomalies like an interatrial septal aneurysm, and atrial septal defect. And LVFT can be evaluated better with three-dimensional TTE than with traditional two-dimensional TTE. Patients with CN should be evaluated more carefully by three-dimensional echocardiography as they can be in synergy in terms of the cardiac pathologies they accompany.