Analysis of the interatrial septum by transesophageal echocardiography in adult cardiac surgical patients: anatomic variants and correlation with patent foramen ovale.
OBJECTIVE
The purpose of this study was to document the perioperative prevalence of anatomic variants of the interatrial septum (IAS), to classify atrial septal aneurysm based on mobility pattern, and to correlate anatomic variants of IAS with patent foramen ovale (PFO).


METHODS
A prospective observational study.


METHODS
University hospital (single institution).


METHODS
Patients presenting for cardiac surgery requiring transesophageal echocardiography.


METHODS
Multiplane TEE in 2 atrial views with color-flow Doppler and contrast echocardiography with a provocative respiratory maneuver.


RESULTS
The cohort size was 206. PFO prevalence was 30.1%. The prevalence of IAS lipomatous hypertrophy was 43.2%, atrial septal flap (ASF) 43.2%, and atrial septal aneurysm (ASA) 28.6%. ASF and ASA were significantly ( p < 0.05) associated with PFO. Selected ASA subtypes are significantly associated with PFO ( p < 0.05).


CONCLUSIONS
IAS anatomic variants are common in adult cardiac surgical patients undergoing multiplane TEE. The presence of ASF and ASA predicts enhanced PFO detection. ASA mobility patterns significantly correlate ( p < 0.05) with the presence of PFO.
Augoustides
John G
JG
Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia, PA 19104-4283, USA. yiandoc@hotmail.com
Weiss
Stuart J
SJ
Ochroch
Andrew E
AE
Weiner
Justin
J
Mancini
Joshua
J
Savino
Joseph S
JS
Cheung
Albert T
AT
D000293:Adolescent; D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging; D006348:Cardiac Surgical Procedures; D002648:Child; D015331:Cohort Studies; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000473:pathology*; D006346:Heart Septum / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies