Echocardiographic Evaluation of Atrial Septal Aneurysm

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Abstract

Background

The atrial septal aneurysm is an abnormality easy to recognize by echocardiographic techniques, associated within teratrial shunting and potential cardiac sources of embolism. The aims of this study were to identify the interatrial shunting and the non hemorrhagic stroke incidence.

Material and method

Patients with atrial septal aneurysm were detected with transthoracic echocardiography. The atrial septal aneurysm was defined as a protrusion of the fossa ovalis at least 10 mm beyond the plane of atrial septum with the base >_ 15 mm. Transthoracic and transesophageal echocardiographic studies was performed in both cases with contrast and Valsalva maneuver.

Results

The study group was 20 patients with atrial septal aneurysm, 11 women and 9 men, with a mean age of 53.1 ± 14.9 years. In 70% (14/20 patients) atrial septal aneurysm was associated with interatrial shunting, identified by transesophageal echocardiographic with contrast and Valsalva maneuver. In the 14 shunt detected it was identified: 71% by transthoracic echocardiographic study with contrast and Valsalva maneuver and 50% by transesophageal color Doppler, transthoracic and transesophageal echocardiographic studies with contrast at rest. In 15% (3/20) the patients with atrial septal aneurysm had experienced a non hemorrhagic stroke without identified source.

Conclusion

1) In 70% atrial septal aneurysm showed interatrial shunting, at least two third part detected by transthoracic echocardiography with contrast and Valsalva maneuver and in the half of the cases with trans-esophageal color Doppler. 2) Atrial septal aneurysm was associated with ischemic strokes in 15% of the patients.