Atrial septal aneurysms in infants and children

Area of Science:

• Pediatric Cardiology
• Echocardiography
• Congenital Heart Disease

Background:

• Interatrial septal aneurysm (IASA) detection has increased with two-dimensional echocardiography (2DE).
• The factors influencing IASA formation and resolution are not fully understood.

Purpose of the Study:

• To determine the prevalence, characteristics, and predisposing factors of IASA in pediatric patients.
• To evaluate the natural history and resolution patterns of IASA.

Main Methods:

• Retrospective analysis of 724 infants, children, and adolescents undergoing 2DE.
• Assessment of IASA prevalence, associated cardiac conditions, and hemodynamic status.
• Follow-up 2DE to monitor changes in IASA size over time.

Main Results:

• A prevalence of 1.7% for IASA was observed in the study group (12 out of 724 patients).
• Eleven of the 12 patients with IASA had abnormal atrial hemodynamics due to structural heart disease or arrhythmias.
• IASAs showed resolution or diminution in patients with normalized hemodynamics, while they enlarged in those with persistent abnormalities.

Conclusions:

• Abnormal atrial hemodynamics are strongly associated with IASA formation in pediatric patients.
• Neonatal atrial septal tissue may be susceptible to aneurysm formation under hemodynamic stress.
• Many IASAs in infants can resolve with maturation and normalization of cardiac hemodynamics.