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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Atrial septal defect in adulthood: a new paradigm for congenital heart disease

Margarita Brida1,2,3, Massimo Chessa4,5, David Celermajer6

  • 1Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton & Harefield Hospitals, National Heart and Lung Institute, Imperial College, Sydney Street, London SW3 6NP, UK.

European Heart Journal
|September 18, 2021
PubMed

Insights

Atrial septal defects (ASDs), common in adults, present complex diagnostic and treatment challenges. This review details optimal management strategies for ASDs, including closure options and managing complications like arrhythmias and pulmonary arterial hypertension.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Adult Congenital Heart Disease

Background:

  • Atrial septal defects (ASDs) are the most frequent congenital heart defect diagnosed in adults.
  • Despite being considered simple, ASDs exhibit anatomical heterogeneity and lead to complications such as arrhythmias, thromboembolism, right heart failure, and pulmonary arterial hypertension (PAH).

Purpose of the Study:

  • To provide clinicians with an updated review on the latest evidence regarding ASD diagnosis and management.
  • To discuss the nuances of optimal diagnostic approaches, treatment strategies, and long-term follow-up for adult patients with ASDs.

Main Methods:

  • Literature review focusing on recent advancements in ASD diagnosis and treatment.
  • Analysis of current guidelines and clinical evidence for managing ASD-related complications.

Main Results:

  • ASD management requires specialized expertise, considering options like catheter or surgical closure.
  • Pre-closure ablation may be indicated for atrial tachycardia, while PAH necessitates targeted therapy or closure suitability assessment.

Conclusions:

  • Optimal ASD care involves a multidisciplinary approach, addressing anatomical variations and potential complications.
  • This review emphasizes the importance of tailored treatment plans and vigilant long-term follow-up for adult ASD patients.

Keywords:
Advanced imagingAtrial septal defectAtrial septal defect surgeryDevice closurePulmonary arterial hypertensionSinus venosus defect

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