Tahara Atsuko, Motoyama Sadako, Malik Shaista, Tahara Nobuhiro, Imaizumi Tsutomu, Saremi Farhood, Sanz Javier, Seto Arnold, Narula Jagat, Krishnan Subramaniam C
Cardiology Division, School of Medicine, University of California, Irvine, Orange, California, USA.
Division of Cardiology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
Clin Anat. 2025 Mar;38(2):158-167. doi: 10.1002/ca.24223. Epub 2024 Oct 10.
We previously described a septal variant termed left atrial septal pouch (LASP). Present in a third of hearts, it results from incomplete fusion of the septum primum (SP) and septum secundum (SS). We assessed the prevalence of LASP using 64-section multidetector computed tomography and further characterized the different variants. Among 864 scans, 770 were of sufficient quality for assessment (428 male, aged 59.2 ± 11.7 years). They were classified on the basis of the degrees of fusion of the SP and SS into a completely fused septum (CFS), patent foramen ovale (PFO), or LASP. The lengths of the SS, SP, and overlapping SP, the maximal length of the foramen ovale (FO) floor, and the atrial dimensions were compared. A PFO was seen in 181 patients (23.5%), a LASP in 242 (31.4%), and a CFS in 339 (44.0%). There were significant differences in the length of the SS (PFO-13.6 ± 4.3 mm, LASP-17.6 ± 4.8 mm, CFS-14.3 ± 7.7 mm, p < 0.001). Hearts with LASPs had a longer overlapping SP than those with PFOs (PFO-6.3 ± 4.5 mm, LASP-13.1 ± 5.2 mm, p < 0.001). The maximal lengths of the FO floor showed differences in short axis (SAX) view (PFO-21.7 ± 4.5 mm, LASP-15.3 ± 4.3 mm, CFS-16.3 ± 4.3 mm, p < 0.001). Hearts with PFO and LASP showed similar SP lengths (27.3 ± 6.6 mm vs. 26.4 ± 6.6 mm, p = 0.10). There was a positive linear correlation between the length of the SS and the overlapping SP (R = 0.28, p < 0.001) with a weaker negative correlation between the SS length and maximal length of the FO floor (R = 0.02, p < 0.001). The groups showed similar atrial dimensions and volumes. Present in a third of patients, hearts with LASP have longer SS and overlapping SP.
我们之前描述过一种间隔变异，称为左心房间隔袋（LASP）。它存在于三分之一的心脏中，是由于原发隔（SP）和继发隔（SS）融合不完全所致。我们使用64层多排螺旋计算机断层扫描评估了LASP的患病率，并进一步对不同变异进行了特征描述。在864次扫描中，770次质量足以进行评估（428名男性，年龄59.2±11.7岁）。根据SP和SS的融合程度，将它们分为完全融合的间隔（CFS）、卵圆孔未闭（PFO）或LASP。比较了SS、SP和重叠SP的长度、卵圆孔（FO）底部的最大长度以及心房尺寸。181例患者（23.5%）发现有PFO，242例（31.4%）有LASP，339例（44.0%）有CFS。SS的长度存在显著差异（PFO-13.6±4.3mm，LASP-17.6±4.8mm，CFS-14.3±7.7mm，p<0.001）。有LASP的心脏比有PFO的心脏重叠SP更长（PFO-6.3±4.5mm，LASP-13.1±5.2mm，p<0.001）。FO底部的最大长度在短轴（SAX）视图中显示出差异（PFO-21.7±4.5mm，LASP-15.3±4.3mm，CFS-16.3±4.3mm，p<0.001）。有PFO和LASP的心脏SP长度相似（27.3±6.6mm对26.4±6.6mm，p=0.10）。SS的长度与重叠SP之间存在正线性相关（R=0.28，p<0.001），而SS长度与FO底部最大长度之间存在较弱的负相关（R=0.02，p<0.001）。各组的心房尺寸和容积相似。三分之一的患者有LASP，有LASP的心脏SS和重叠SP更长。
