An Atrial Septal Ridge Diagnosed by Transesophageal Echocardiography

A left atrial ridge is an anomaly of irregular fusion between the septum primum and septum secundum.1 Aberrant fusion of the septa results in thickened and fibrotic tissue along the region of the fossa ovalis that will occasionally protrude into the left atrium.2 The presence of a left atrial ridge...

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Main Authors: Rowa H. Attar, Amr Telmesani, Nadeen N. Faza
Format: Article
Language:English
Published: Houston Methodist DeBakey Heart & Vascular Center 2022-04-01
Series:Methodist DeBakey Cardiovascular Journal
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Online Access:https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1099
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author Rowa H. Attar
Amr Telmesani
Nadeen N. Faza
author_facet Rowa H. Attar
Amr Telmesani
Nadeen N. Faza
author_sort Rowa H. Attar
collection DOAJ
description A left atrial ridge is an anomaly of irregular fusion between the septum primum and septum secundum.1 Aberrant fusion of the septa results in thickened and fibrotic tissue along the region of the fossa ovalis that will occasionally protrude into the left atrium.2 The presence of a left atrial ridge has multiple clinical implications due to its close proximity to the fossa ovalis. The location of this uncommon incongruence may make transseptal catheter-based approaches more challenging, underscoring the importance of imaging guidance to determine the ideal transseptal puncture site. Figure 1 shows cardiac images of a 64-year-old female with a history of severe mitral regurgitation, atrial fibrillation, sick sinus syndrome status post pacemaker implantation, pulmonary hypertension, systemic lupus erythematosus, and chronic kidney disease. She was seen by the valve team and underwent a transesophageal echocardiogram (TEE) to determine candidacy for transcatheter edge-to-edge repair of the mitral valve. Two-dimensional biplane imaging of the interatrial septum (IAS) shows a linear structure on the left atrial side of the fossa ovalis. Three-dimensional imaging of the IAS revealed that the structure was consistent with an atrial septal ridge.
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spelling doaj-art-e4167cc541d34839a05833b285f0cd5e2025-08-20T02:22:17ZengHouston Methodist DeBakey Heart & Vascular CenterMethodist DeBakey Cardiovascular Journal1947-61082022-04-01181141610.14797/mdcvj.1099875An Atrial Septal Ridge Diagnosed by Transesophageal EchocardiographyRowa H. Attar0Amr Telmesani1Nadeen N. Faza2https://orcid.org/0000-0002-0601-8741Houston Methodist DeBakey Heart & Vascular Center, Houston, TexasHouston Methodist DeBakey Heart & Vascular Center, Houston, TexasHouston Methodist DeBakey Heart & Vascular Center, Houston, TexasA left atrial ridge is an anomaly of irregular fusion between the septum primum and septum secundum.1 Aberrant fusion of the septa results in thickened and fibrotic tissue along the region of the fossa ovalis that will occasionally protrude into the left atrium.2 The presence of a left atrial ridge has multiple clinical implications due to its close proximity to the fossa ovalis. The location of this uncommon incongruence may make transseptal catheter-based approaches more challenging, underscoring the importance of imaging guidance to determine the ideal transseptal puncture site. Figure 1 shows cardiac images of a 64-year-old female with a history of severe mitral regurgitation, atrial fibrillation, sick sinus syndrome status post pacemaker implantation, pulmonary hypertension, systemic lupus erythematosus, and chronic kidney disease. She was seen by the valve team and underwent a transesophageal echocardiogram (TEE) to determine candidacy for transcatheter edge-to-edge repair of the mitral valve. Two-dimensional biplane imaging of the interatrial septum (IAS) shows a linear structure on the left atrial side of the fossa ovalis. Three-dimensional imaging of the IAS revealed that the structure was consistent with an atrial septal ridge.https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1099atrial septal ridgetransesophageal echocardiographytransseptal access
spellingShingle Rowa H. Attar
Amr Telmesani
Nadeen N. Faza
An Atrial Septal Ridge Diagnosed by Transesophageal Echocardiography
Methodist DeBakey Cardiovascular Journal
atrial septal ridge
transesophageal echocardiography
transseptal access
title An Atrial Septal Ridge Diagnosed by Transesophageal Echocardiography
title_full An Atrial Septal Ridge Diagnosed by Transesophageal Echocardiography
title_fullStr An Atrial Septal Ridge Diagnosed by Transesophageal Echocardiography
title_full_unstemmed An Atrial Septal Ridge Diagnosed by Transesophageal Echocardiography
title_short An Atrial Septal Ridge Diagnosed by Transesophageal Echocardiography
title_sort atrial septal ridge diagnosed by transesophageal echocardiography
topic atrial septal ridge
transesophageal echocardiography
transseptal access
url https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1099
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AT amrtelmesani anatrialseptalridgediagnosedbytransesophagealechocardiography
AT nadeennfaza anatrialseptalridgediagnosedbytransesophagealechocardiography
AT rowahattar atrialseptalridgediagnosedbytransesophagealechocardiography
AT amrtelmesani atrialseptalridgediagnosedbytransesophagealechocardiography
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