Large Atrial Septal Aneurysm Associated with Secundum Atrial Septal Defect

Isakadze, Nino; Lovell, Jana; Shapiro, Edward P.; Choi, Chun Woo; Williams, Marlene S.; Mukherjee, Monica

doi:10.1016/j.case.2022.02.003

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…A study by Giannopoulos et al enrolled over 4500 children and found that ASA diagnosed with echocardiogram only presented as an isolated structural cardiac defect in 35.5% (17/47) of patients, while the remaining patients with confirmed ASA all had associated interatrial shunting present [3]. Several other reports support this unique relationship between ASAs with congenital heart defects including atrial septal defect, patent foramen ovale (PFO), and sinus venosus defect [4,13,14]. Furthermore, there is a strong relationship between the development of systemic thromboembolism in patients with ASA and interatrial wall defects.…”

Section: Discussionmentioning

confidence: 99%

Atrial Septal Aneurysm: An Incidental Finding or a Clinically Significant Anomaly?

Imburgio¹,

Wiseman²,

Udongwo³

et al. 2022

Cureus

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Atrial septal aneurysm (ASA) is a condition involving the bulging of the interatrial septum into one or both of the atrial chambers. We present the case of an ASA found on transesophageal echocardiogram in a patient who presented with exertional dyspnea. This case report aims to highlight the growing clinical association of ASA with arterial embolism through various mechanisms and emphasize the unknown aspects of clinical management for such patients. While there are currently no clear recommendations on whether to start anticoagulation after an ASA is diagnosed, many suggest a careful patient-centered approach for such decisions due to the reported increased risk of thromboembolic events. Further studies regarding the significance of ASA and cardioembolic events are needed.

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Section: Discussionmentioning

confidence: 99%

Atrial Septal Aneurysm: An Incidental Finding or a Clinically Significant Anomaly?

Imburgio¹,

Wiseman²,

Udongwo³

et al. 2022

Cureus

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“…Аневризмы могут сочетаться с небольшим дефектом по типу открытого овального окна (тип А), большим дефектом, как при вторичном ДМПП (тип В), с двумя (тип С) или множественными (тип D) перфорациями межпредсердной перегородки [9]. Как правило, аневризмы, диагностированные в младенчестве, спонтанно уменьшаются [10].…”

Section: резюме _____________________________________________________...unclassified

Atrial Septal Defect & Patent Foramen Ovale: Features of Ultrasound Diagnostics, Treatment and Monitoring in Children at the Present Stage

Дроздовская¹,

Касаб²,

Строгий³

2023

Педиатрия. Восточная Европа

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Дефект межпредсердной перегородки является одним из наиболее распространенных врожденных пороков сердца не только в детском возрасте, но и среди взрослых. Такая особенность обусловлена поздней диагностикой порока на фоне длительного отсутствия клинических симптомов. Ведущим методом диагностики является ультразвуковое исследование сердца, которое способствует не только определению локализации и размеров дефекта, но и раннему установлению легочной гипертензии, что необходимо учитывать при проведении у детей хирургического лечения и дальнейшем ведении в послеоперационном периоде. Возникают трудности в определении показаний к закрытию дефекта межпредсердной перегородки и открытого овального окна у взрослых. К таким показаниям относят: перенесенный ранее инсульт, наличие фибрилляции предсердий, тромбофилии, тромбоэмболии легочной артерии и другие причины. Таким образом, актуальность проблемы ведения пациентов с дефектом межпредсердной перегородки и открытым овальным окном обусловлена широкой распространенностью данных межпредсердных коммуникаций, необходимостью их ранней диагностики и лечения в детском возрасте, у взрослого населения – особенностями наблюдения и хирургического лечения открытого овального окна и дефекта межпредсердной перегородки. Atrial septal defect is one of the most common congenital heart defects not only in childhood, but also among adults. This feature is due to the late diagnosis of the defect against the background of a long absence of clinical symptoms. The leading diagnostic method in this case is cardiac ultrasound, which contributes not only to determining defect localization and size, but also to early detection of pulmonary hypertension, which must be taken into account when performing surgical treatment in children and further management in postoperative period. Some difficulties arise in determining indications for closure of interatrial septal defect and open oval window in adults due to previous stroke, presence of atrial fibrillation, thrombophilia, pulmonary embolism in the history, and other reasons. Thus, the relevance of the considered issue of managing patients with atrial septal defect and patient foramen ovale is determined by the high prevalence of these interatrial communications, and the need for their early diagnosis and treatment in childhood, and by observational features and surgical treatment of patent foramen ovale and atrial septal defect in adults.

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“…It includes defects that involve the true septal membrane and those that allow communication between both atria [ 1 ]. Aneurysmal ASDs refer to an abnormal localized bulging or enlargement of the atrial septum, with an incidence of 1-2.5% in the general population [ 2 ], while typical ASDs involve a straightforward, uniform defect in the interatrial septum without any associated aneurysm formation [ 3 ]. The management of patients with aneurysmal ASDs poses challenges as it requires careful observation and earlier intervention to mitigate complications such as cardioembolic stroke.…”

Section: Introductionmentioning

confidence: 99%

Navigating the Complexities: Addressing the Challenges of Aneurysmal Atrial Septal Defects

Sandeep,

Singha,

Kalbande

et al. 2024

Cureus

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Aneurysmal atrial septal defects (ASDs) represent a rare subset of congenital cardiac anomalies, characterized by bulging of the interatrial septum. This condition poses unique challenges in diagnosis, management, and outcomes due to its variable clinical presentation and associated complications. While echocardiography remains the cornerstone of diagnosis, advanced imaging modalities such as cardiac magnetic resonance imaging (MRI) and computed tomography (CT) may provide additional insights. Optimal management strategies for aneurysmal ASDs require careful consideration of patient-specific factors, including the size and location of the defect, associated cardiovascular abnormalities, and the presence of pulmonary hypertension. Surgical repair, whether through conventional open-heart techniques or transcatheter interventions, remains the primary treatment modality; however, the approach may vary based on individual patient characteristics. Anesthetic considerations, including hemodynamic monitoring and perioperative care, are crucial in optimizing outcomes and reducing the risk of complications during surgical interventions. Long-term follow-up is essential to monitor potential complications such as residual shunting, arrhythmias, and the development of pulmonary vascular disease. Collaborative efforts among cardiologists, cardiothoracic surgeons, anesthesiologists, and other multidisciplinary specialists are paramount in providing comprehensive care for patients with aneurysmal ASDs.

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Large Atrial Septal Aneurysm Associated with Secundum Atrial Septal Defect

Cited by 3 publications

References 15 publications

Atrial Septal Aneurysm: An Incidental Finding or a Clinically Significant Anomaly?

Atrial Septal Aneurysm: An Incidental Finding or a Clinically Significant Anomaly?

Atrial Septal Defect & Patent Foramen Ovale: Features of Ultrasound Diagnostics, Treatment and Monitoring in Children at the Present Stage

Navigating the Complexities: Addressing the Challenges of Aneurysmal Atrial Septal Defects

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