Status of patent foramen ovale, atrial septal aneurysm, atrial septal defect and aortic arch atheroma as risk factors for stroke

During the last few years, there has been emphasis on the role of the interatrial septum and the aortic arch atheroma in the genesis of stroke. The causal relationship of these disorders with stroke is still controversial because direct evidence may be lacking. The diagnosis is often presumed and based on indirect signs, i.e. by visualization of the interatrial septal or aortic arch abnormalities which are detectable by transesophageal echocardiography. The optimal therapeutic strategy including some more invasive treatments, such as surgery, is uncertain. In this article, we review the current knowledge concerning the interatrial septum and aortic arch disorders as risk factors for stroke and current therapeutic strategies.