Document Detail

Septal pouch in the left atrium: a new anatomical entity with potential for embolic complications.
MedLine Citation:
PMID:  20129577     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this study was to develop a better understanding of the pathophysiology of the condition, we studied the patterns by which the septum primum (SP) and septum secundum (SS) fuse.
BACKGROUND: A patent foramen ovale (PFO) is a communication across the interatrial septum between a nonadherent SP and SS and is considered to be a risk factor for serious clinical syndromes.
METHODS: We examined the interatrial septum in 94 randomly selected autopsied hearts, with a focus on the SP and SS and the patterns by which the 2 structures fuse.
RESULTS: Of the 94 specimens that were suitable for analysis, 26 (27.66%) had a PFO. Of the remaining 68 hearts, complete fusion of the SP and SS along the entire zone of overlap was seen in 27 (28.7%) hearts. In the remaining 41 hearts (60.29%), a PFO was absent, but incomplete fusion of the SP and SS was seen. Of 41 hearts, 37 (90%) had a septal pouch that opened into the left atrial (LA) cavity. Four hearts (10%) had a pouch accessible from the right atrium. Hearts with left-sided pouches tended to be younger (50 +/- 18 years of age) than hearts where there was complete fusion (age 63 +/- 23 years) (p = 0.06).
CONCLUSIONS: Our data suggest that when a foramen ovale closes spontaneously, the SP and SS fuse initially at the caudal limit of the zone of overlap of the 2 structures. This incomplete fusion results in a pouch that, in the majority of instances, communicates with the LA cavity.
Subramaniam C Krishnan; Miguel Salazar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  3     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-04     Completed Date:  2010-04-28     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  98-104     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Aged, 80 and over
Echocardiography, Transesophageal
Embolism / etiology*,  pathology
Foramen Ovale, Patent / complications,  pathology*
Heart Atria / abnormalities
Heart Septal Defects / complications,  pathology*,  ultrasonography
Middle Aged
Young Adult

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