Five cases of pilots with eustachian valve mecism diagnosed by color Doppler ultrasound cardiogram and literature review

Objective To discuss the echocardiography diagnosis on the pilots with eustachian valve (EV) mecism and the clinical significance. Methods The eustachian valve mecism in 5 pilots was diagnosed by color Doppler ultrasound cardiogram, and the shape, position, motion, attachment point of the overlong venous sinus valve in right atria were observed and the influences on hemodynamics were discussed. The type, diagnosis, clinic significance and aeromedical determination of EV were concluded by reviewing literature in terms of it. Results There were 5 cases of pilots with EV mecism, and ultrasound cardiogram showed a light ribbon moving in the right atrium which length ranged from 35 to 47 mm and the width ranged from 3 to 4 mm. One side of the ribbon connected with inferior vena cava, and the other side extended to the interior wall of right atrium where the middle of atrial septum and the tricuspid valve annulus located at (one case associated with ventricular septal aneurysm). There was no hemodynamics change detected by ultrasound cardiogram. Therefore, all 5 pilots were qualified for flight. Conclusions Ultrasound cardiogram is an accurate, rapid and convenient method to diagnose EV mecism. EV remaining in right atria commonly has no clinical manifestation, but associated with thrombosis, arrhythmia, catheter entrapmen in the interventional therapy. Even the pilots with EV usually have no clinic manifestation and no subjective symptoms in flight, and their flight endurance is seemed in good condition. But the close supervision and periodical follow-up are still suggested. Key words: Vena cava, inferior; Echocardiography, Doppler, color; Eligibility determination; Pilots