Atrial Septal Aneurysm Does Not Predispose to Stroke in the Immediate Postoperative Period Following Cardiac Surgery

The postoperative period following cardiac surgery is associated with an increased incidence of cerebrovascular events. Previous retrospective studies have suggested that atrial septal aneurysms (ASAs) are associated with embolic strokes ranging in incidence from 20%-52%. The purpose of the study was to investigate whether patients with ASA undergoing cardiac surgery have increased risk for strokes in the immediate postoperative period. Of 1626 consecutive patients undergoing transesophageal echocardiography during cardiac surgery over a 44-month period, 80 patients were identified to have ASA (incidence 4.9%). Patients were followed during their entire hospital stay for development of any neurological event. Any patient with a suspicion of neurological event had a detailed neurological history, examination, and, if necessary, a CT scan or MRI study. Most patients were started on aspirin postoperatively. None of the patients experienced a cerebrovascular event or systemic embolization during this period. Thus, the presence of isolated ASA may not pose an additional risk for cerebrovascular events during postoperative period.