{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:28Z","timestamp":1787014108318,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,11,11]],"date-time":"2015-11-11T00:00:00Z","timestamp":1447200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2015,12]]},"abstract":"\n An atrial septal pouch (\n ASP<\/jats:styled-content>\n ) results from partial fusion of the septum primum and the septum secundum, and depending on the site of fusion, the pouch can be left\u2010sided (\n LASP<\/jats:styled-content>\n ) or right\u2010sided (\n RASP<\/jats:styled-content>\n ).\n LASP<\/jats:styled-content>\n s have been described in association with thrombi found in patients admitted with acute strokes, raising awareness of its potential cardioembolic role, especially in those with no other clearly identifiable embolic source. We retrospectively studied 39 patients in whom the presence of an\n ASP<\/jats:styled-content>\n had been identified by three\u2010dimensional transesophageal echocardiography (3\n DTEE<\/jats:styled-content>\n ) and who had a two\u2010dimensional transesophageal echocardiogram (2\n DTEE<\/jats:styled-content>\n ) performed during the same clinical encounter. The incremental value provided by 3\n DTEE<\/jats:styled-content>\n over 2\n DTEE<\/jats:styled-content>\n included the detection of six\n ASP<\/jats:styled-content>\n s not found by 2\n DTEE<\/jats:styled-content>\n ; the detection of two\n ASP<\/jats:styled-content>\n s in the same subject (in four patients) not identified by 2\n DTEE<\/jats:styled-content>\n ; larger\n ASP<\/jats:styled-content>\n measurements of length and height in over 80% of the cases; and measurement of the\n ASP<\/jats:styled-content>\n width (elevational axis) for the calculation of the area of the\n ASP<\/jats:styled-content>\n opening, because of its unique capability to view the pouch en face. In addition, the volume of\n ASP<\/jats:styled-content>\n and of the echogenic masses contained in the\n ASP<\/jats:styled-content>\n (four of 39 patients) could be calculated by 3\n DTEE<\/jats:styled-content>\n , which is a superior parameter of size characterization when compared to individual dimensions. One of these patients who presented with ischemic stroke diagnosed by magnetic resonance imaging had a large (>2 cm) mass in a\n LASP<\/jats:styled-content>\n , with echolucencies similar to those seen in thrombi and associated with clot lysis and resolution. This mass completely disappeared on anticoagulant therapy lending credence that it was most likely a thrombus. There was no history of stroke or any other type of embolic event in the other three patients with masses in\n ASP<\/jats:styled-content>\n . In conclusion, this retrospective study highlights the incremental value of 3\n DTEE<\/jats:styled-content>\n over 2\n DTEE<\/jats:styled-content>\n in the comprehensive assessment and characterization of\n ASP<\/jats:styled-content>\n s, which can aid in the clarification of their role in cryptogenic stroke patients.\n <\/jats:p>","DOI":"10.1111\/echo.13111","type":"journal-article","created":{"date-parts":[[2015,11,11]],"date-time":"2015-11-11T06:24:48Z","timestamp":1447223088000},"page":"1858-1867","source":"Crossref","is-referenced-by-count":17,"title":["Incremental Value of Live\/Real Time Three\u2010Dimensional over Two\u2010Dimensional Transesophageal Echocardiography in the Assessment of Atrial Septal Pouch"],"prefix":"10.1111","volume":"32","author":[{"given":"Mahmoud","family":"Elsayed","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming C.","family":"Hsiung","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cheng Hsin General Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. David","family":"Meggo\u2010Quiroz","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Elguindy","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Begum","family":"Uygur","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Tandon","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tolga","family":"Guvenc","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurgul","family":"Keser","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sakarya University Medical Faculty Sakarya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa G.","family":"Vural","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sakarya University Medical Faculty Sakarya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serkan","family":"Bulur","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jugal R.","family":"Chahwala","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firoozeh","family":"Abtahi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navin C.","family":"Nanda","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,11,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2010.11.003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2009.07.017"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl051"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2010.11.001"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2012.09.021"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.12.024"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jep116"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.04.135"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-11-0090"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.22087"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2010.10.003"},{"key":"e_1_2_7_13_1","unstructured":"Atlas of Transesophageal Echocardiography. 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