Cor Vasa 2020, 62(3):251-256 | DOI: 10.33678/cor.2020.013

Role of transthoracic echocardiography in the detection of atrial septal aneurysm and intracardial shunts of PFO type in ambulatory practice

Jan Pavlovič^a,b,c, Jana Rubáčková Popelová^b, Martin Mates^d

^a Outpatient Clinic IP Pavlova, Prague

^b Department of Heart Surgery, Complex Heart Center, Na Homolce Hospital, Prague

^c Hořovice Hospital, Hořovice

^d Department of Cardiology, Complex Heart Center, Na Homolce Hospital, Prague

Aims: This study evaluates the usage of TTE as a screening method to detect ASA as is demonstrated on the population of patients examined within the period of one year.

Methods: From January 2019 to January 2020, 769 patients underwent TTE on outpatient basis. 87% of these with either good or very good image quality were analyzed for the presence of ASA. In the presence of ASA, and in the case of patient's interest, CTTE was performed.

Results: We have identified 80 patients with ASA out of which 37 underwent contrast examination. 34 of these were positive for the presence of R-L shunt. Around 18% of patients with ASA exhibited symptoms, which were likely or possibly of embolic origin. Those, whose symptoms were suspicious of cardioembolism were treated with antiplatelet medication (n = 6) or PFO occluder together with antiplatelet medication (n = 2).

Conclusion: According to this study the prevalence of ASA is around 10% in the general cardiologist's population. The proportion of interatrial shunting, detected by CTTE, in the group of patients with ASA was nearly 90%, which is significantly higher than in most of the works published to date. The percentage of patients with possible or probable cardioembolic symptoms was around 18%. On the basis of these results we suggest to assess the presence of ASA during every echocardiographic examination and to perform some form of contrast examination in all patients with ASA. All symptomatic patients should undergo TEE-CTEE.

Keywords: Atrial septal aneurysm, Contrast echocardiography, Occluder, PFO

Received: January 13, 2020; Revised: February 11, 2020; Accepted: February 12, 2020; Published: July 29, 2020  Show citation