Double Inter-atrial Septum: A Rare Cause of Cardioembolic Stroke

Incidental Finding of a Double Interatrial Septum in an Elderly Female Undergoing Coronary Artery Bypass Graft Surgery

“…The presence of 2 interatrial septa is thought to result either from abnormal development of the SS, with failure of resorption of the superior portion of the SP in utero, or the additional septum is most likely to be a persistent left venous valve of the sinus venosus. 1 Thrombotic occlusion of the left circumflex artery due to a coronary embolus originating from the double interatrial septum has been reported. 5,6 Isolated double interatrial septum is an even rarer occurrence.…”

The Case of Isolated Double Atrial Septum with Persistent Interatrial Space

“…Double atrial septum is extremely rare congenital anomaly, which has double-walled atrial septum that distinguishes midline interatrial chamber between the two atria 1)2). This interatrial space sometimes distinguished from left atrium by septum primum, otherwise from right atrium by accessory septal structure 2)3).…”

“…In some aspects, the accessory septal structure distinguishes this space from right atrium, it is presumed it might be persistent left ventricular (LV) valve attached to sinus venosus in fetal period 4). And clinically, most cases of this anomaly are asymptomatic unless manifest as thromboembolic complications,1)5) such as stroke, or transient ischemic attack, that thrombus may be originated from this interatrial space. To date, there has been no case report in Korea, we encountered and reported a rare case of incidentally found isolated double atrial septum by transthoracic echocardiography (TTE).…”

Double interatrial septum with persistent interatrial chamber: A rare but clinically significant anomaly

“…1 This clinical entity has been reported in the literature among the patients from the age of 16 to 91 years who presented either with thromboembolic episodes or were diagnosed incidentally. 4 The embryological explanation for the development of double interatrial septum is uncertain. The defect is characterized by the presence of two distinct interatrial septa enclosing a midline interatrial chamber and mostly occurs either due to abnormal development of septum secundum, or due to failure of the resorption of the superior portion of septum primum, or rarely due to persistent left venous valve of sinus venosus.…”

“…1 Usually, this chamber is separated from the left atrium by septum primum and from the right atrium by an accessory atrial septum (AAS). 4,5 This interatrial space usually communicates with left atrium via patent foramen ovale (PFO), and with right atrium via accessory atrial septal fenestration (ASF). 1 These two passages (PFO and ASF) are usually formed at different levels, such as superior and inferior.…”