Does the morphology of atrial septal aneurysm influence cerebral arterial embolus occurrence?

Atrial septal aneurysm (ASA) is a rare heart defect regarded as a source of arterial emboli. The main objective of the study was to assess the role of ASA morphology in the etiology of embolism.

Eighty-eight subjects were included after transthoracic echocardiography positive for ASA. Medical history of embolic events was obtained in 13 patients (14.8%). Magnitude, location, size of aneurysm, oscillation, direction of bulging, the presence of interatrial shunt and source of any potential cardiac embolus material were assessed, and the size of the left atrium, the area of both atria, and the presence of any valve prolapse syndrome were recorded. The occurrence of atrial fibrillation or flutter and the presence of concomitant diseases and other clinical features were also estimated.

The occurrence of arterial emboli was not related to ASA morphology. Coexisting diseases, smoking and left atrial dimension were significantly correlated with the occurrence of arterial emboli.

Ischemic events were not significantly correlated with the ASA presence. The present findings suggest other causes of vascular events in patients with ASA.