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Atrial septal pouch - Morphological features and clinical considerations.

Authors :: Hołda MK
Koziej M
Hołda J
Piątek K
Tyrak K
Chołopiak W
Bolechała F
Walocha JA
Klimek-Piotrowska W
Source :: International journal of cardiology [Int J Cardiol] 2016 Oct 01; Vol. 220, pp. 337-42. Date of Electronic Publication: 2016 Jun 28.
Publication Year :: 2016
Abstract: Background: The atrial septal pouch (SP) is a new anatomical entity within the interatrial septum. The left-sided SP may be the source of thrombus and contribute to ischemic stroke. The aim of this study was to provide a detailed morphometric description of the SP.<br />Methods: Two hundred autopsied hearts (23% deriving from females) with a mean age of 46.7±19.1years were investigated. We assessed the morphology of the interatrial septum. We obtained measurements and casts of the SPs, and we conducted histological staining of the left-sided SPs.<br />Results: Patent foramen ovale was observed in 25% of hearts. We found a left SP in 41.5%, right in 5.5% and a double SP in 5.5% of hearts. We found the patent foramen ovale (PFO) more often in younger hearts, and the SP and smooth septum were more prevalently found in older hearts (p=.0023). The mean volume of the left-sided SP was 0.31±0.11ml, which represented 13.6±9.4% (range: 3.1-44.9%) of the left atrial appendage volume. The SP shape resembled a cone or a cylinder with some smaller diverticula originating from the main body. The SP free wall was composed of two layers of endocardium, transverse muscle fibers and connective tissue.<br />Conclusions: A left-sided SP was present in 47% of individuals. The SP arises as a result of PFO channel closure. The anatomy of left-sided SP may promote blood stasis and thrombus formation. The universal formula for SP volume was calculated.<br /> (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)