Aj. Burger et al., LOW INCIDENCE OF CEREBROVASCULAR EVENTS IN PATIENTS WITH INCIDENTAL ATRIAL SEPTAL ANEURYSM, Echocardiography, 14(6), 1997, pp. 589-595
Objectives: The purpose of our investigation teas to describe the echo
cardiographic characteristics of an atrial septal aneurysm (ASA) and a
ssociated cardiac abnormalities, to determine whether any echocardiogr
aphic characteristics are associated with cerebrovascular events, and
to compare the cerebrovascular risk of ASA when it is an, isolated and
incidental finding with ASA associated with other cardiac abnormaliti
es and diagnostic indications, including, a cardiac source of embolus.
Methods: In 1605 consecutive patients referred for transesophageal ec
hocardiography during open heart surgery, we identified 78 patients wi
th ASA as an incidental finding (Group I). During the same period, thi
s anomaly was found in 39 of 8014 consecutive patients referred to the
echocardiographic laboratory for various diagnostic reasons (Group II
). The frequency of cerebrovascular events and ASA characteristics was
compared between these two groups. Results: A total of 117 patients w
ith ASA was included in the study: 60 males and 57 females with a mean
age of 66.7 +/- 9.1 years. There were no significant differences in t
he echocardiographic characteristics of ASA or associated cardiac abno
rmalities between these two groups; no intracardiac or ASA associated
thrombi were detected in either group. While only 6.4% of Group I had
a clinical event, 23% of patients in Group II had a stroke or transien
t ischemic abnormality. Conclusions: The morphological characteristics
of ASA and associated cardiac abnormalities do not distinguish patien
ts at risk for cerebrovascular events. Although the presence of ASA ma
y be a risk factor for embolic strokes, this risk is Lower than previo
usly thought.