Hostname: page-component-7c8c6479df-ph5wq Total loading time: 0 Render date: 2024-03-28T20:41:09.511Z Has data issue: false hasContentIssue false

Atrial septal aneurysms in childhood: prevalence, classification, and concurrent abnormalities

Published online by Cambridge University Press:  07 June 2013

Andreas Giannopoulos
Affiliation:
Paediatric Cardiology Unit, AHEPA University Hospital, Greece
Christoforos Gavras*
Affiliation:
Paediatric Cardiology Unit, AHEPA University Hospital, Greece
Stavroula Sarioglou
Affiliation:
Paediatric Cardiology Unit, AHEPA University Hospital, Greece
Fotini Agathagelou
Affiliation:
Paediatric Cardiology Unit, AHEPA University Hospital, Greece
Irene Kassapoglou
Affiliation:
Paediatric Cardiology Unit, AHEPA University Hospital, Greece
Fani Athanassiadou
Affiliation:
B Department of Paediatrics, AHEPA University Hospital, Thessaloniki, Greece
*
Correspondence to: C. Gavras, MD, PhD, Paediatric Cardiology Unit, AHEPA University Hospital, Stilp Kyriakidi 1, Thessaloniki 54636, Greece. Tel: +00302351029822; Fax: +00302310994736; E-mail: christoforosgavras@hotmail.com

Abstract

Objectives: This study sought to investigate the prevalence of atrial septal aneurysms in the paediatric population and to define coexisting abnormalities and their incidence. Background: Few papers refer to the prevalence of atrial septal aneurysms in childhood. Methods: We enrolled a total of 4522 children aged more than 12 months who underwent a transthoracic echocardiography. Atrial septal aneurysm was defined as a protrusion of the interatrial septum or part of it >15 mm beyond the plane of the atrial septum or phasic excursion of the interatrial septum during the cardiorespiratory cycle of at least 15 mm in total amplitude and a diameter of the base of the aneurysm of at least 15 mm. Results: Atrial septal aneurysms were found in 47 children (1.04%). They involved almost the entire septum in 14 patients (28.89%) and were limited to the fossa ovalis in 33 (71.11%). An atrial septal aneurysm was an isolated structural defect in 17 (35.56%). In 30 (64.44%) patients, it was associated with interatrial shunting – atrial septal defect and patent foramen ovale. At the echo follow-up after a year, no changes were recorded. Conclusions: Prevalence of atrial septal aneurysms is almost 1%. The most common abnormalities associated are interatrial shunts, that is, a patent foramen ovale and an atrial septal defect. From a medical point of view, it is suggested that no action is to be taken during childhood, as a child with an atrial septal aneurysm is not at increased risk compared with a child without one. Follow-up is scheduled on an individual basis.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Olivares-Reyes, A, Chan, S, Lazar, EJ, Bandlamudi, K, Narla, V, Ong, K. Atrial septal aneurysm: a new classification in two hundred five adults. J Am Soc Echocardiogr 1997; 10: 644656.CrossRefGoogle ScholarPubMed
2. Lang, FJ, Posselt, A. Aneurrysmatische Vorwolburg der Fossa ovalis in den linken Vorhof. Wien Med Wochenschr 1934; 84: 392396.Google Scholar
3. Olivares-Reyes, A, Al-Kamme, A, Gonzalez, J. Atrial septal aneurysm: a study in five hundred adult patients. Retrieved Jan 5, 2005, from http://www.fac.org.ar/revista/00v29n4/congreso/premio3.PDF Google Scholar
4. Wolf, WJ, Casta, A, Sapire, DW. Atrial septal aneurysm in infants and children. Am Heart J 1987; 113: 11491153.CrossRefGoogle ScholarPubMed
5. Ozcelik, N, Atalay, S, Tutar, E, Ekici, F. Prevalence of interatrial septal aneurysm in newborns and their natural course. Pediatr Cardiol 2006; 27: 343346.CrossRefGoogle ScholarPubMed
6. Schneider, B, Hanrath, P, Vogel, P, Meinertz, T. Improved morphologic characterization of atrial septal aneurysm by transesophageal echocardiography: relation to cerebrovascular events. J Am Coll Cardiol 1990; 16: 10001009.CrossRefGoogle ScholarPubMed
7. Pearson, AC, Nagelhout, D, Castello, R, Gomez, C, Labovitz, A. Atrial septal aneurysm and stroke: a transesophageal echocardiographic study. J Am Coll Cardiol 1991; 18: 12231229.CrossRefGoogle ScholarPubMed
8. Agmon, Y, Khandeheria, BK, Meissner, I, et al. Frequency of atrial septal aneurysms in patients with cerebral ischemic events. Circulation 1999; 99: 19421944.CrossRefGoogle ScholarPubMed
9. Meissner, I, Whisnant, JP, Khandheria, BK, et al. Prevalence of potential risk factors for stroke assessed by transesophageal echocardiography and carotid ultrasonography: The SPARC Study. Mayo Clin Proc 1999; 74: 862869.CrossRefGoogle ScholarPubMed
10. Mattioli, V, Aquilina, M, Oldani, A, Longhini, C, Mattioli, G. Atrial septal aneurysm as a cardioembolic source in adult patients with stroke and normal carotid arteries. Eur Heart J 2001; 22: 261268.CrossRefGoogle ScholarPubMed
11. Hung, JH, Lu, JH, Hung, CY. Prenatal diagnosis of atrial septal aneurysm. J Clin Ultrasound 2008; 36: 5152.CrossRefGoogle ScholarPubMed
12. Hanley, PC, Tajik, AJ, Hynes, JK, et al. Diagnosis and classification of atrial septal aneurysm by two-dimensional echocardiography: report of 80 consecutive cases. J Am Coll Cardiol 1985; 6: 13701382.CrossRefGoogle ScholarPubMed
13. Lai, WW, Geva, T, Shirali, GS, et al. Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 2006; 19: 14131430.CrossRefGoogle ScholarPubMed
14. Silver, MD, Dorsey, JS. Aneurysms of the septum primum in adults. Arch Pathol Lab Med 1978; 102: 6265.Google ScholarPubMed
15. Cabanes, L, Mas, JL, Cohen, A, et al. Atrial septal aneurysm and patent foramen ovale as risk factors for cryptogenic stroke in patients less than 55 years of age. A study using trans-esophageal echocardiography. Stroke 1993; 24: 18651873.CrossRefGoogle Scholar
16. Mugge, A, Daniel, WG, Angermann, C, et al. Atrial septal aneurysm in adult patients: a multicenter study using transthoracic and transesophageal echocardio-graphy. Circulation 1995; 91: 27852792.CrossRefGoogle Scholar
17. Marazanof, M, Roudaut, R, Cohen, A, et al. Atrial septal aneurysm: morphologic characteristics in a large population: pathological associations: a French multicenter study on 259 patients investigated by transoesophageal echocardiography. Int J Cardiol 1995; 52: 5965.CrossRefGoogle Scholar
18. Overell, JR, Bone, I, Lees, KR. Interatrial septal abnormalities and stroke: a meta-analysis of case–control studies. Neurology 2000; 55: 11721179.CrossRefGoogle ScholarPubMed
19. Mas, JL, Arquizan, C, Lamy, C, et al. Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm or both. N Engl J Med 2001; 345: 17401746.CrossRefGoogle ScholarPubMed
20. Homma, S, Sacco, RL. Patent foramen ovale and stroke. Circulation 2005; 112: 10631072.CrossRefGoogle ScholarPubMed
21. Kizer, JR, Devereux, RB. Patent foramen ovale in young adults with unexplained stroke. N Engl J Med 2005; 353: 23612372.CrossRefGoogle ScholarPubMed
22. Saver, JL. Cryptogenic stroke in patients with patent foramen ovale. Curr Atheroscler Rep 2007; 9: 319325.CrossRefGoogle ScholarPubMed
23. Ueno, Y, Shimada, Y, Tanaka, R, et al. Patent foramen ovale with atrial septal aneurysm may contribute to white matter lesions in stroke patients. Cerebrovasc Dis 2010; 30: 1522.CrossRefGoogle ScholarPubMed
24. Morelli, S, Voci, P, Morabito, G, et al. Atrial septal aneurysm and cardiac arrhythmias. Int J Cardiol 1995; 49: 257265.CrossRefGoogle ScholarPubMed
25. Belkin, RN, Kisslo, J. Atrial septal aneurysm: recognition and clinical relevance. Am Heart J 1990; 120: 948957.CrossRefGoogle ScholarPubMed
26. Wilmhurst, PT, Nightingale, S, Walsh, KP, Morrison, WL. Effect on migraine of closure of cardiac right-to-left shunts to prevent recurrence of decompression illness or stroke or for haemodynamic reasons. Lancet 2000; 356: 16481651.CrossRefGoogle Scholar
27. Carerj, S, Narborne, MC, Zito, C, et al. Prevalence of atrial septal aneurysm in patients with migraine: an echo cardiographic study. Headache 2003; 43: 725728.CrossRefGoogle Scholar
28. Scholz, PE, Zitron, E, Katus, AH, Karle, AC, Mereles, D. Atrial septal aneurysm mimicking ECG signs of enlarged right atrium. Europace 2007; 9: 475476.CrossRefGoogle ScholarPubMed
29. Paraskevaidis, IA, Tsiapras, D, Kyrzopoulos, S, Kremastinos, DT. Familial origin of atrial septal aneurysm. Am J Cardiol 2006; 97: 148150.CrossRefGoogle ScholarPubMed
30. Werren, M, Alberti, E. Clinical implications of familial occurrence of atrial septal aneurysm. G Ital Cardiol 2008; 9: 579582.Google ScholarPubMed