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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Quantitation of contrast TCD in patients with and without atrial septal aneurysm

Wendy C Ziai1, Sangjin Oh, Alexander Y Razumovsky

  • 1Division of Neurosciences Critical Care, and Department of Neurology, Johns Hopkins Hospital, 600 North Wolfe Street/Meyer 8-140, Baltimore, MD, 21287, USA. weziai@jhmi.edu

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|June 14, 2005
PubMed

Insights

Patients with atrial septal aneurysm (ASA) and patent foramen ovale (PFO) do not show increased right-to-left shunting via contrast transcranial Doppler ultrasonography. This finding suggests ASA may not elevate stroke risk through greater shunting in PFO patients.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Patients with atrial septal aneurysm (ASA) and patent foramen ovale (PFO) exhibit higher recurrent ischemic event rates than PFO alone.
  • Increased right-to-left shunting is a hypothesized explanation for this elevated risk.

Purpose of the Study:

  • To investigate whether the combination of ASA and PFO leads to a greater degree of right-to-left shunting compared to PFO alone.
  • To assess the impact of ASA on shunting in patients experiencing transient ischemic attack or cryptogenic ischemic stroke.

Main Methods:

  • Retrospective study involving 46 patients with PFO, utilizing contrast transcranial Doppler ultrasonography (c-TCD).
  • Comparison of 8 patients with PFO and ASA against 38 patients with PFO but without ASA.

Main Results:

  • No significant difference in embolic counts was observed between patients with and without ASA.
  • Valsalva maneuver increased emboli, particularly in individuals with large PFOs.

Conclusions:

  • ASA in conjunction with PFO does not appear to increase the risk of right-to-left shunting as measured by c-TCD.
  • The study suggests that ASA may not be a primary driver of increased shunting in PFO-associated ischemic events.
Abstract

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