Defects in the Oval Fossa: Morphologic Variations and Impact on Transcatheter Closure

Vettukattil, Joseph J.; Zaheer, Ahmed; Salmon, Anthony P.; Mohun, Tomothy; Anderson, Robert H.

doi:10.1016/j.echo.2012.10.019

Cited by 17 publications

(23 citation statements)

References 10 publications

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“…Also Vettukattil reported making the diagnosis of a MASP in one of two patients in whom the device embolized retrospectively, while in the other patient, the association between embolization and malattachment was not made at the time of the procedure despite identifying the “spiral formation” of the septum. Similar to previous reports , the degree of malattachment, meaning the distance between SP and SS, had a wide variation, with ASD patients having a greater variation (2.5–13 mm) compared to PFO patients (1.6–4 mm). SP was the furthest away from SS in the posterior leftward aspect.…”

Section: Discussionsupporting

confidence: 87%

“…Recent introduction of real time 3D TEE may further improve analysis of the septal anatomy and help identifying potential risk factors for procedural failure . It has been suggested that the enhanced spatial orientation of 3D TEE without frequent angle adjustments or probe manipulations may be especially useful in detection of MASP, since this septal variant may be missed by 2D imaging . In our study population, the diagnosis of MASP was made by 2D TTE and TEE in all patients and was not a retrospective diagnosis.…”

Section: Discussionmentioning

confidence: 95%

“…The separation between SP and SS also has been found to be a nidus for thrombus formation . Recently, a MASP was referred to result in a spiral atrial communication and was reported to be associated with device embolization after transcatheter ASD/PFO closure . Overall, 13/328 patients (4%) were found to have a MASP: 9/142 ASD patients (6.3%) and 4/186 PFO patients (2.2%).…”

Section: Discussionmentioning

confidence: 99%

“…Overall, 13/328 patients (4%) were found to have a MASP: 9/142 ASD patients (6.3%) and 4/186 PFO patients (2.2%). Vettukattil et al reported a prevalence of 5.7% (6/105) of spiral septal communication among patients who were scheduled for transcatheter ASD or PFO closure over a 4‐year study period. We believe that this variant of the atrial septum anatomy has been underappreciated in the past in patients with an interatrial communication.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Malattached septum primum and deficient septal rim predict unsuccessful transcatheter closure of atrial communications

Ostermayer

Srivastava

Doucette

et al. 2015

Cathet Cardio Intervent

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Malattached septum primum and deficient septal rim predict unsuccessful transcatheter closure of atrial communications

Ostermayer

Srivastava

Doucette

et al. 2015

Cathet Cardio Intervent

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“…Two main anatomic variants of the interatrial septum are “lipomatous” septum and large septal aneurysm, and both can be clearly demonstrated by two‐dimensional TEE as well as by CT or CMR, although three‐dimensional TEE and CT‐derived images are anatomically the most accurate . Moreover, three‐dimensional TEE can also be helpful in assessing the orientation of the atrial septal defects (ASDs) margins that are proven to be crucial for the detection of patients at risk of embolization of devices used for percutaneous closure …”

Section: Right Atrial Anatomymentioning

confidence: 99%

The right atrium, a forgotten cardiac chamber: An updated review of multimodality imaging

Tadić

2015

J. Clin. Ultrasound

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Despite several limitations, two-dimensional echocardiography (2DE) is the standard method for assessing the right atrium (RA) in everyday clinical routine. Cardiac magnetic resonance remains the current "gold standard" for RA visualization and volume quantification. The development of 2DE-derived strain imaging has enabled assessing RA deformation and phasic function in various pathologic conditions. Three-dimensional echocardiography was demonstrated to be more accurate and reproducible than 2DE for cardiac chamber quantification, while also allowing the evaluation of RA phasic function without geometric assumption. The purpose of this review is to summarize currently available data about RA anatomy, phasic function, and mechanics acquired by different imaging modalities.

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The Development of Septation in the Four‐Chambered Heart

Anderson

Spicer

Brown

et al. 2014

The Anatomical Record

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The past decades have seen immense progress in the understanding of cardiac development. Appreciation of precise details of cardiac anatomy, however, has yet to be fully translated into the more general understanding of the changing structure of the developing heart, particularly with regard to formation of the septal structures. In this review, using images obtained with episcopic microscopy together with scanning electron microscopy, we show that the newly acquired information concerning the anatomic changes occurring during separation of the cardiac chambers in the mouse is able to provide a basis for understanding the morphogenesis of septal defects in the human heart. It is now established that as part of the changes seen when the heart tube changes from a short linear structure to the looped arrangement presaging formation of the ventricles, new material is added at both its venous and arterial poles. The details of these early changes, however, are beyond the scope of our current review. It is during E10.5 in the mouse that the first anatomic features of septation are seen, with formation of the primary atrial septum. This muscular structure grows toward the cushions formed within the atrioventricular canal, carrying on its leading edge a mesenchymal cap. Its cranial attachment breaks down to form the secondary foramen by the time the mesenchymal cap has used with the atrioventricular endocardial cushions, the latter fusion obliterating the primary foramen. Then the cap, along with a mesenchymal protrusion that grows from the mediastinal mesenchyme, muscularizes to form the base of the definitive atrial septum, the primary septum itself forming the floor of the oval foramen. The cranial margin of the foramen is a fold between the attachments of the pulmonary veins to the left atrium and the roof of the right atrium. The apical muscular ventricular septum develops concomitant with the ballooning of the apical components from the inlet and outlet of the ventricular loop. Its apical part is initially trabeculated. The membranous part of the septum is derived from the rightward margins of the atrioventricular cushions, with the muscularizing proximal outflow cushions fusing with the muscular septum and becoming the subpulmonary infundibulum as the aorta is committed to the left ventricle. Perturbations of these

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Defects in the Oval Fossa: Morphologic Variations and Impact on Transcatheter Closure

Cited by 17 publications

References 10 publications

Malattached septum primum and deficient septal rim predict unsuccessful transcatheter closure of atrial communications

Malattached septum primum and deficient septal rim predict unsuccessful transcatheter closure of atrial communications

The right atrium, a forgotten cardiac chamber: An updated review of multimodality imaging

The Development of Septation in the Four‐Chambered Heart

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