{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:32:45Z","timestamp":1781659965100,"version":"3.54.5"},"reference-count":24,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Purpose: To evaluate the prevalence and cardiac CT features of inferior left atrial diverticula (ILAD) communicating with the right atrium (RA) or inferior vena cava (IVC), a novel type of interatrial communication. Materials and Methods: This retrospective study included 11,512 consecutive patients who underwent cardiac CT. CT features and prevalence of ILAD communicating with the RA or IVC were analyzed. Shunts were defined as anatomical defects between the two structures with or without visible contrast flow. In a subset of the patients we compared interatrial septal aneurysm (n = 20) and ILAD without shunt (n = 66), assessing the involvement of a wedge-like fatty space bordered by both atria, IVC and coronary sinus. Results: There were 33 patients (19 males and 14 females; aged 59.8 \u00b1 11.2 years; age range, 18\u201387 years) with ILAD with shunts (ILADSs). The prevalence of ILADSs was 4.2% (33\/783) among ILAD and 0.3% (33\/11,512) among all patients. Maximal dimensions of ILAD were 17.6 \u00b1 9.9 mm (range, 5.3\u201341.0 mm). Mean ostial diameters of ILAD and mean sizes of shunts were 6.2 \u00b1 5.6 mm and 3.2 \u00b1 2.9 mm, respectively. Shunts were larger than 5 mm in 6 patients (15.2%) and larger than 3 mm in 10 patients (30.3%). In 30 patients who underwent transthoracic echocardiography, ILADSs were not identified at echocardiography. CT showed involvement of the wedge-like fatty space for all ILAD and for no cases with interatrial septal aneurysm. Conclusions: Cardiac CT enables detection of incidental ILADSs unrecognized at echocardiography.<\/jats:p>","DOI":"10.3390\/jcdd13050215","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T10:25:16Z","timestamp":1779099916000},"page":"215","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Inferior Left Atrial Diverticulum Communicating with the Right Atrium or Inferior Vena Cava: Prevalence and CT Features"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5692-3248","authenticated-orcid":false,"given":"Hae Jin","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Radiology, Daejeon Eulji Medical Center, Eulji University, Daejeon 35233, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Goo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Radiology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5124-605X","authenticated-orcid":false,"given":"Sung-A","family":"Chang","sequence":"additional","affiliation":[{"name":"Cardiovascular Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea"},{"name":"Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyoung","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Hyuk","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, Department of Cardiothoracic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Mok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea"},{"name":"Cardiovascular Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9983-048X","authenticated-orcid":false,"given":"Yeon Hyeon","family":"Choe","sequence":"additional","affiliation":[{"name":"Department of Radiology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea"},{"name":"Cardiovascular Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.diii.2015.02.011","article-title":"MDCT of interatrial septum","volume":"96","author":"Yasunaga","year":"2015","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S2837","DOI":"10.21037\/jtd.2018.02.18","article-title":"Anatomy of the atrial septum and interatrial communications","volume":"10","author":"Naqvi","year":"2018","journal-title":"J. Thorac. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jcin.2009.07.017","article-title":"Septal pouch in the left atrium: A new anatomical entity with potential for embolic complications","volume":"3","author":"Krishnan","year":"2010","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_4","first-page":"227","article-title":"Anatomo-functional characterization of interatrial septum for catheter-based interventions","volume":"1","author":"Rigatelli","year":"2011","journal-title":"Am. J. Cardiovasc. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s00392-010-0149-3","article-title":"Incidence and predictors of atrial fibrillation following transcatheter closure of interatrial septal communications using contemporary devices","volume":"99","author":"Wagdi","year":"2010","journal-title":"Clin. Res. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1111\/jce.12213","article-title":"Left atrial diverticula in patients undergoing atrial fibrillation ablation: Morphologic analysis and clinical impact","volume":"24","author":"Lumia","year":"2013","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.echo.2019.01.009","article-title":"Revisiting Anatomy of the Interatrial Septum and its Adjoining Atrioventricular Junction Using Noninvasive Imaging Techniques","volume":"32","author":"Faletra","year":"2019","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.1093\/eurheartj\/ehp214","article-title":"Left atrium wall diverticulum: An additional anatomical consideration in atrial fibrillation catheter ablation","volume":"30","author":"Zamorano","year":"2009","journal-title":"Eur. Heart J."},{"key":"ref_9","first-page":"505","article-title":"Imaging Assessment of the Interatrial Septum for Transcatheter Atrial Septal Defect and Patent Foramen Ovale Closure","volume":"6","author":"Bechis","year":"2017","journal-title":"Interv. Cardiol. Clin."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1159\/000495573","article-title":"Left-Sided Atrial Septal Pouch as a Risk Factor of Cryptogenic Stroke: A Systematic Review and Meta-Analysis","volume":"46","author":"Koziej","year":"2018","journal-title":"Cerebrovasc. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e37\u201346","DOI":"10.1016\/j.ejrad.2010.11.017","article-title":"Multidetector CT of left atrium","volume":"81","author":"Balli","year":"2012","journal-title":"Eur. J. Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.3348\/jksr.2022.0170","article-title":"Diagnostic Performance of Cardiac CT and Transthoracic Echocardiography for Detection of Surgically Confirmed Bicuspid Aortic Valve: Effect of Calcium Extent and Valve Subtypes","volume":"84","author":"Kim","year":"2023","journal-title":"J. Korean Soc. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1136\/heartjnl-2020-318127","article-title":"Multimodality imaging anatomy of interatrial septum and mitral annulus","volume":"107","author":"Faletra","year":"2020","journal-title":"Heart"},{"key":"ref_15","first-page":"542","article-title":"The incidence of left atrial diverticula in coronary CT angiography","volume":"18","author":"Incedayi","year":"2012","journal-title":"Diagn. Interv. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1016\/j.crad.2013.02.005","article-title":"Presence of left atrial diverticula, accessory appendages, and normal variant pulmonary venous anatomy diagnosed using MDCT and adverse outcomes following radiofrequency catheter ablation therapy in patients with drug-refractory atrial fibrillation: An exploratory study","volume":"68","author":"Patel","year":"2013","journal-title":"Clin. Radiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s00276-019-02382-w","article-title":"The characteristics of left atrial diverticula in normal sinus rhythm patients","volume":"42","year":"2020","journal-title":"Surg. Radiol. Anat."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s00276-008-0427-1","article-title":"The anatomical study of left atrium diverticulum by multi-detector row CT","volume":"31","author":"Wan","year":"2009","journal-title":"Surg. Radiol. Anat."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1002\/ca.22320","article-title":"Anatomical features and clinical importance of left atrial diverticula: MDCT findings","volume":"27","author":"Solak","year":"2014","journal-title":"Clin. Anat."},{"key":"ref_20","first-page":"2010","article-title":"Development and Validation of a Diagnostic Echocardiographic Mass Score in the Approach to Cardiac Masses","volume":"15","author":"Paolisso","year":"2022","journal-title":"J. Am. Coll. Cardiol. Cardiovasc. Imaging"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1148\/radiol.2492080175","article-title":"Imaging of patent foramen ovale with 64-section multidetector CT","volume":"249","author":"Saremi","year":"2008","journal-title":"Radiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s43044-024-00504-3","article-title":"Prevalence and characteristics of patent foramen ovale in a sample of Egyptian population: A computed tomography study","volume":"76","author":"Shehata","year":"2024","journal-title":"Egypt. Heart J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e240371","DOI":"10.1148\/ryct.240371","article-title":"Spectrum of Interatrial Shunts Presenting with an Intact Atrial Septum: Imaging Features at Echocardiography, CT, and MRI","volume":"7","author":"Lim","year":"2025","journal-title":"Radiol. Cardiothorac. Imaging"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"W331","DOI":"10.2214\/AJR.09.3689","article-title":"Partially unroofed coronary sinus: MDCT and MRI findings","volume":"195","author":"Kim","year":"2010","journal-title":"AJR Am. J. 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