Atrial septal pouch — Morphological features and clinical considerations

Hołda, Mateusz K.; Koziej, Mateusz; Hołda, Jakub; Piątek, Katarzyna; Tyrak, Kamil; Chołopiak, Weronika; Bolechała, Filip; Walocha, Jerzy; Klimek‐Piotrowska, Wiesława

doi:10.1016/j.ijcard.2016.06.141

Cited by 46 publications

(84 citation statements)

References 24 publications

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“…The maximum depth (D) and ostium height (H) of the pouches were measured in the multi-planar reconstruction for MSCT. The BiCaval 90°-120° view was used when measuring in 2D-TEE, which anatomically corresponds to the long axis of the SP [1]. The 2D-TEE measurements were performed in the 60-70% phase (diastole).…”

Section: Image Interpretationmentioning

confidence: 99%

“…The ostium height (H) was defined for left-sided SPs as the maximum distance between its free wall and left atrial wall and for right-sided SPs as the largest distance between the fossa ovalis floor and the left surface of the antero-superior rim. The SP volume was calculated using the formula: [1]. All of the measurements were made by two independent researchers (M.K.H and A.K-O.)…”

Section: Image Interpretationmentioning

confidence: 99%

“…The atrial septal pouch (SP) is a new anatomical entity within the human interatrial septum [1,2]. A SP is a kangaroo pouch-like structure (diverticulum) that occurs when the patent foramen ovale (PFO) channel is absent but the septum primum and septum secundum are partially fused, with no connection between both atria.…”

Section: Introductionmentioning

confidence: 99%

“…A SP is a kangaroo pouch-like structure (diverticulum) that occurs when the patent foramen ovale (PFO) channel is absent but the septum primum and septum secundum are partially fused, with no connection between both atria. The diverticulum may be located either on the left or right side of the interatrial septum; left and right SPs may also coexist in the same heart (double SP) [1]. The term "left-sided SP" describes a pouch located on the left side of the interatrial septum (left and double); while the "right-sided SP" is used when the pouch is present on the right side of the septum (right and double).…”

Section: Introductionmentioning

confidence: 99%

“…The term "left-sided SP" describes a pouch located on the left side of the interatrial septum (left and double); while the "right-sided SP" is used when the pouch is present on the right side of the septum (right and double). The high prevalence of SPs (over 50% of the healthy population) indicates that the pouch is not a pathology, but rather is an element of normal human anatomy [1,[3][4][5]. However, the left-sided SP, as an element of human morphology, may play a significant clinical role in the pathogenesis of cerebrovascular accidents and atrial fibrillation.…”

Section: Introductionmentioning

confidence: 99%

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Cardiac computed tomography compared with two-dimensional transesophageal echocardiography for the detection and assessment of atrial septal pouches

Hołda

Krawczyk‐Ożóg

Koziej

et al. 2018

Int J Cardiovasc Imaging

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The aim of this study is to compare the two-dimensional transesophageal echocardiography (2D-TEE) with multi-slice computed tomography (MSCT) and with autopsied material to evaluate the ability and precision of the imaging methods for the detection and assessment of septal pouch (SP). One hundred and fifty patients that underwent both 2D-TEE and MSCT and 50 autopsied human hearts were investigated. In MSCT, the interatrial septum was classified as a left SP in 37.3%, right SP in 3.3%, and patent foramen ovale (PFO) channel in 3.3%. In 2D-TEE, the interatrial septum was classified as a left SP in 39.3%, right SP in 11.3%, double SP in 4.7%, and PFO channel in 2.0%. The weighted kappa coefficient between MSCT and 2D-TEE in assessing the septum morphology was 0.59. The prevalence of the left SP is lower when it is evaluated by MSCT or 2D-TEE than by anatomical study, but this difference is insignificant (37.3% vs. 44.0%, p = 0.40, and 39.3% vs. 44.0%, p = 0.56, respectively). The prevalence of left SPs is lower when detected by MSCT or 2D-TEE than during autopsy, but the difference is statistically insignificant (37.3% vs. 44.0%, p = 0.40, and 39.3% vs. 44.0%, p = 0.56, respectively). Both 2D-TEE and MSCT are comparable techniques for detecting left-sided SPs with the insignificant lower prevalence of detecting left-sided SPs compared to autopsied material. However, TEE with the contrast seems to be superior over MSCT due to the possibility of unambiguous PFO channel detection. Therefore, TEE with contrast should be preferred over MSCT in the identification of left-sided SPs.

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Section: Image Interpretationmentioning

confidence: 99%

Section: Image Interpretationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cardiac computed tomography compared with two-dimensional transesophageal echocardiography for the detection and assessment of atrial septal pouches

Hołda

Krawczyk‐Ożóg

Koziej

et al. 2018

Int J Cardiovasc Imaging

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The Left Atrial Septal Pouch: A New Stroke Risk Factor?

Kapoor

Wadi

Becerra

et al. 2021

Transl. Stroke Res.

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The left atrial septal pouch (LASP) occurs due to incomplete fusion of septa primum and secundum at the inter-atrial septum, creating an open flap that may serve as a thromboembolic source. Prior studies have demonstrated increased prevalence of LASP in cryptogenic strokes. The aim of the current study was to validate the above findings in a separate, larger group of stroke and non-stroke patients. We examined transesophageal echocardiograms (TEEs) performed between July 2011 and December 2018. LASP prevalence was determined in TEEs referred for ischemic stroke or transient ischemic attack (“stroke”) and compared with LASP prevalence in patients undergoing TEEs for other reasons (“non-stroke”). Stroke subtyping was performed using the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. There were 306 TEEs from 144 non-stroke and 162 stroke patients. Mean age and sex distribution were 56 ± 1 (mean ± SE) and 65% male in the non-stroke group and 58 ± 1 and 54% male in the stroke group. The overall prevalence of LASP was 31%. The prevalence of LASP was 28% (41/144) in non-stroke patients, 25% (24/95) in non-cryptogenic stroke patients, and 43% (29/67) in cryptogenic stroke patients. LASP prevalence was significantly higher in the cryptogenic subgroup compared with the non-cryptogenic subgroup (p = 0.02). These findings demonstrate a significant association of LASP with risk of cryptogenic stroke, suggesting that LASP may serve as a thromboembolic nidus. Additional studies are needed to determine the generalizability of these findings, and their therapeutic implications, supporting LASP as a stroke risk factor.

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Porcine heart interatrial septum anatomy

Hołda

Koziej

et al. 2018

Annals of Anatomy - Anatomischer Anzeiger

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Atrial septal pouch — Morphological features and clinical considerations

Cited by 46 publications

References 24 publications

Cardiac computed tomography compared with two-dimensional transesophageal echocardiography for the detection and assessment of atrial septal pouches

Cardiac computed tomography compared with two-dimensional transesophageal echocardiography for the detection and assessment of atrial septal pouches

The Left Atrial Septal Pouch: A New Stroke Risk Factor?

Porcine heart interatrial septum anatomy

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