Exaggerated posterior aortic wall excursion. A new echocardiographic feature of atrial septal defect with left to right shunt?

In 32 adult patients with a secundum type atrial septal defect (ASD) and normal pulmonary vascular resistance, the posterior aortic wall excursion (AoE) was measured using M-mode echocardiography, before, 16.2 +/- 4.5 days after, and 2.4 +/- 1.1 years after operative repair of the ASD. This parameter was also measured in 50 control subjects. The AoE index (AoE corrected for body surface area) in patients with ASD was significantly greater than in disease-free subjects (0.81 vs 0.59 cm, p less than 0.01). When the AoE index was plotted against the pulmonary to systemic blood flow ratio (Qp/Qs) obtained by the Fick method, a single linear relationship was evident (r = 0.65, p less than 0.01). The index normalized within 1 month after the operation; left ventricular dimension index became normal only 1 year after the operation. The right ventricular dimension index remained enhanced even 1 year after the operation. We suggest that exaggerated AoE might be another echocardiographic feature of ASD with normal pulmonary vascular resistance.