• John G Augoustides, Stuart J Weiss, Andrew E Ochroch, Justin Weiner, Joshua Mancini, Joseph S Savino, and Albert T Cheung.
• Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia, PA 19104-4283, USA. yiandoc@hotmail.com
• J. Cardiothorac. Vasc. Anesth. 2005 Apr 1; 19 (2): 146-9.

ObjectivesThe purpose of this study was to document the perioperative prevalence of anatomic variants of the interatrial septum (IAS), to classify atrial septal aneurysm based on mobility pattern, and to correlate anatomic variants of IAS with patent foramen ovale (PFO).DesignA prospective observational study.SettingUniversity hospital (single institution).ParticipantsPatients presenting for cardiac surgery requiring transesophageal echocardiography.InterventionsMultiplane TEE in 2 atrial views with color-flow Doppler and contrast echocardiography with a provocative respiratory maneuver.Measurements And Main ResultsThe cohort size was 206. PFO prevalence was 30.1%. The prevalence of IAS lipomatous hypertrophy was 43.2%, atrial septal flap (ASF) 43.2%, and atrial septal aneurysm (ASA) 28.6%. ASF and ASA were significantly ( p < 0.05) associated with PFO. Selected ASA subtypes are significantly associated with PFO ( p < 0.05).ConclusionsIAS anatomic variants are common in adult cardiac surgical patients undergoing multiplane TEE. The presence of ASF and ASA predicts enhanced PFO detection. ASA mobility patterns significantly correlate ( p < 0.05) with the presence of PFO.

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