Atrial Septal Aneurysm in Adult Patients

Atrial septal aneurysm (ASA) is a localized deformity, generally at the level of fossa ovalis, seen asa protrusion of the atrial septum to the right or the left atrium or both. ASA is easily diagnosed by transesophageal echocardiography (TEE). We aimed to study the incidence, associated abnormalities and elinical significance of ASA in patients undergoing TEE examination. 1712 patients undergoing TEE w ere enrolled in the study. Five-hundred eightythree patients were excluded because of a diagnosis of rheumatic valve disease. ASA was defined as a bulging of the atrial septum to the right atrium or the left atrium or both for 1 cm or more. Forty-three patients (3.8%) had ASA. Twenty eight were women and 15 men. Mean age was 41.0 ± 16.7 . Related abnormalities were patent foramen ovale (27.9%), atrial septal defect (23.3%), mitral valve prolapses (20.9%) and Ebstein's anomaly (2.3%). 25.6% of ASA existed as isolated anomaly. Five patients (11.6%) had a history of cerebrovascular accident (CVA). Four of these had no other etiologic factor for CVA. In conclusion, ASA is found in 3.8% of patients undergoing TEE, frequently associated with patent foramen ovale, atrial septal defect or mitral valve prolapses. It should not be ignored as a potential risk factor for stroke.