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

  • Andreas Giannopoulos (a1), Christoforos Gavras (a1), Stavroula Sarioglou (a1), Fotini Agathagelou (a1), Irene Kassapoglou (a1) and Fani Athanassiadou (a2)...

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.

Corresponding author
Correspondence to: C. Gavras, MD, PhD, Paediatric Cardiology Unit, AHEPA University Hospital, Stilp Kyriakidi 1, Thessaloniki 54636, Greece. Tel: +00302351029822; Fax: +00302310994736; E-mail:
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1. A Olivares-Reyes , S Chan , EJ Lazar , K Bandlamudi , V Narla , K Ong . Atrial septal aneurysm: a new classification in two hundred five adults. J Am Soc Echocardiogr 1997; 10: 644656.

4. WJ Wolf , A Casta , DW Sapire . Atrial septal aneurysm in infants and children. Am Heart J 1987; 113: 11491153.

5. N Ozcelik , S Atalay , E Tutar , F Ekici . Prevalence of interatrial septal aneurysm in newborns and their natural course. Pediatr Cardiol 2006; 27: 343346.

6. B Schneider , P Hanrath , P Vogel , T Meinertz . Improved morphologic characterization of atrial septal aneurysm by transesophageal echocardiography: relation to cerebrovascular events. J Am Coll Cardiol 1990; 16: 10001009.

7. AC Pearson , D Nagelhout , R Castello , C Gomez , A Labovitz . Atrial septal aneurysm and stroke: a transesophageal echocardiographic study. J Am Coll Cardiol 1991; 18: 12231229.

8. Y Agmon , BK Khandeheria , I Meissner , et al. Frequency of atrial septal aneurysms in patients with cerebral ischemic events. Circulation 1999; 99: 19421944.

9. I Meissner , JP Whisnant , BK Khandheria , 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.

10. V Mattioli , M Aquilina , A Oldani , C Longhini , G Mattioli . Atrial septal aneurysm as a cardioembolic source in adult patients with stroke and normal carotid arteries. Eur Heart J 2001; 22: 261268.

11. JH Hung , JH Lu , CY Hung . Prenatal diagnosis of atrial septal aneurysm. J Clin Ultrasound 2008; 36: 5152.

12. PC Hanley , AJ Tajik , JK Hynes , 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.

13. WW Lai , T Geva , GS Shirali , 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.

15. L Cabanes , JL Mas , A Cohen , 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.

16. A Mugge , WG Daniel , C Angermann , et al. Atrial septal aneurysm in adult patients: a multicenter study using transthoracic and transesophageal echocardio-graphy. Circulation 1995; 91: 27852792.

17. M Marazanof , R Roudaut , A Cohen , 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.

18. JR Overell , I Bone , KR Lees . Interatrial septal abnormalities and stroke: a meta-analysis of case–control studies. Neurology 2000; 55: 11721179.

19. JL Mas , C Arquizan , C Lamy , et al. Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm or both. N Engl J Med 2001; 345: 17401746.

20. S Homma , RL Sacco . Patent foramen ovale and stroke. Circulation 2005; 112: 10631072.

21. JR Kizer , RB Devereux . Patent foramen ovale in young adults with unexplained stroke. N Engl J Med 2005; 353: 23612372.

22. JL Saver . Cryptogenic stroke in patients with patent foramen ovale. Curr Atheroscler Rep 2007; 9: 319325.

23. Y Ueno , Y Shimada , R Tanaka , et al. Patent foramen ovale with atrial septal aneurysm may contribute to white matter lesions in stroke patients. Cerebrovasc Dis 2010; 30: 1522.

24. S Morelli , P Voci , G Morabito , et al. Atrial septal aneurysm and cardiac arrhythmias. Int J Cardiol 1995; 49: 257265.

25. RN Belkin , J Kisslo . Atrial septal aneurysm: recognition and clinical relevance. Am Heart J 1990; 120: 948957.

26. PT Wilmhurst , S Nightingale , KP Walsh , WL Morrison . 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.

27. S Carerj , MC Narborne , C Zito , et al. Prevalence of atrial septal aneurysm in patients with migraine: an echo cardiographic study. Headache 2003; 43: 725728.

28. PE Scholz , E Zitron , AH Katus , AC Karle , D Mereles . Atrial septal aneurysm mimicking ECG signs of enlarged right atrium. Europace 2007; 9: 475476.

29. IA Paraskevaidis , D Tsiapras , S Kyrzopoulos , DT Kremastinos . Familial origin of atrial septal aneurysm. Am J Cardiol 2006; 97: 148150.

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Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
  • URL: /core/journals/cardiology-in-the-young
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