Background: Aortic root dilatation and patent foramen ovale (PFO) are two separate medical conditions; altered geometry due to aortic root dilatation may lead to hinder the complete closure of the foramen ovale.However, the relationship between both is not well-established and requires further research.

Aim: was to explore the relation between PFO & aortic root dilatation.

Methods: This case-control study was carried out in the Department of Cardiology, Minia University Hospital, during the period from May 2022 to May 2024; the study including 210 participants they were classified into two groups: Group I including 120 participants who had dilated aortic root and Group II including 90 participants as a control group. All the participants were subjected to: Transthoracic echocardiography and Transesophageal echocardiography. Multiplane TEE was used to identify PFO shunt either spontaneously, under valsalva or agitated saline injection. PFO shunt degree was classified as small, moderate or large.

Results: This study showed non statistically significant increase number of PFO 12 (10%) in group I compared to 6 (6.7 %) in group II (p=0.694). PFO was clearly visualized in 3 participants, using valsalva maneuver in 6 participants and using contrast study in 9 participants. 12 PFO shunt were small and 6 were moderate in degree.

Conclusion: Based on the results of this study, we observed increased number and percentage of PFO in patients with aortic root dilatation. This may support the possibility of changing the anatomical conformation of inter atrial septum by aortic root dilatation.

Keywords: patent foramen ovale, aortic root dilatation