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Unrepaired Congenital Shunt Lesions in Adults: Principles for Clinical Management

Diana Mariela Mouratian1, Judith Beatriz Ackerman2, Laura Mariana Riznyk3

  • 1Cardiology Department, Hospital Nacional de Pediatría Juan P. Garrahan, Buenos Aires, Argentina.

Methodist Debakey Cardiovascular Journal
|July 6, 2026
PubMed

Insights

This review covers unrepaired congenital heart shunts in adults, focusing on diagnosis, management, and when to close defects. It emphasizes personalized treatment decisions for better patient outcomes.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease

Background:

  • Congenital heart defects can remain undiagnosed until adulthood.
  • Shunt lesions present unique challenges in adult patients.
  • Delayed diagnosis impacts long-term cardiovascular health.

Purpose of the Study:

  • To review the pathophysiology of adult congenital shunt lesions.
  • To outline diagnostic strategies for these conditions.
  • To discuss management principles, including defect closure decisions.

Main Methods:

  • Literature review of pathophysiology, clinical presentation, and diagnosis.
  • Analysis of management principles and surgical indications.
  • Emphasis on individualized decision-making for defect closure.

Main Results:

  • Adults with congenital shunts exhibit diverse presentations.
  • Diagnostic approaches involve imaging and hemodynamic assessment.
  • Management requires careful consideration of risks and benefits of closure.

Conclusions:

  • Individualized assessment is crucial for managing adult congenital shunt lesions.
  • Defect closure indications and contraindications must be carefully weighed.
  • Optimal management improves outcomes for adult patients with congenital heart disease.

Keywords:
adult congenital heart diseasefollow-up and treatmentpulmonary hypertensionshunt lesions

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