An Atrial Septal Ridge Diagnosed by Transesophageal Echocardiography

Area of Science:

• Cardiology
• Cardiac Imaging
• Anatomical Variations

Background:

• A left atrial ridge is an anatomical variation resulting from irregular fusion of the septum primum and septum secundum.
• This aberrant fusion leads to thickened, fibrotic tissue near the fossa ovalis, potentially protruding into the left atrium.

Observation:

• A case study involving a 64-year-old female with multiple comorbidities presented for mitral valve assessment.
• Transesophageal echocardiography (TEE) was performed to evaluate candidacy for transcatheter edge-to-edge repair.
• Two- and three-dimensional imaging revealed a linear structure on the left atrial side of the interatrial septum, consistent with an atrial septal ridge.

Findings:

• The study identified a left atrial ridge, an uncommon cardiac anomaly.
• Imaging confirmed the ridge's presence and location adjacent to the fossa ovalis.

Implications:

• Left atrial ridges can complicate transseptal catheter-based procedures.
• Advanced imaging guidance is essential for identifying safe transseptal puncture sites in patients with this anomaly.
• Understanding this variation is key for procedural planning and patient safety in interventional cardiology.