[Aneurysms of the atrial septum]

Aneurysms of the atrial septum (ASA) frequently diagnosed since the introduction of transoesophageal echocardiography are implicated in the aetiology of cerebral and systemic embolic events. This update was undertaken to resume recent data on this pathology and its relationship with embolic events. The diagnostic criteria are described together with the morphological features (size, movements, thickness) and associated abnormalities (interatrial shunts, valvular prolapse). The authors summarise the data concerning possible complications of ASA, especially the different mechanisms invoked to explain embolism (paradoxical embolism. thrombosis in situ, supraventricular arrhythmias). Therapeutic options are discussed with respect to the clinical contexts (therapeutic abstention, platelet antiaggregant drugs, oral anticoagulants, interventional cardiology or surgery.