title: Analysis of the interatrial septum by transesophageal echocardiography in adult cardiac surgical patients: anatomic variants and correlation with patent foramen ovale.
abstract: 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.
authors.affiliation: Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia, PA 19104-4283, USA. yiandoc@hotmail.com
authors.forename: John G
authors.initials: JG
authors.lastname: Augoustides
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Weiss
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Ochroch
authors.forename: Justin
authors.initials: J
authors.lastname: Weiner
authors.forename: Joshua
authors.initials: J
authors.lastname: Mancini
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Savino
authors.forename: Albert T
authors.initials: AT
authors.lastname: Cheung
mesh_terms: 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