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Indications for closure and medical management of atrial septal defects in adults

Heidi M Connolly, MD, FASE
Section Editor
Candice Silversides, MD, MS, FRCPC
Deputy Editor
Susan B Yeon, MD, JD, FACC


Atrial septal defect (ASD) is the most common congenital lesion in adults after bicuspid aortic valve. Although the defect often causes no symptoms until adulthood, potential complications of an undetected ASD include atrial arrhythmias, paradoxical embolization, cerebral abscess, right ventricular failure, and pulmonary hypertension that can become irreversible and lead to right-to-left shunting (Eisenmenger syndrome).

This topic will review indications for closure and medical management of ASDs in adults.

Surgical and percutaneous closure of ASDs, pathophysiology, anatomy, natural history, and clinical features of ASDs in adults, the identification and assessment of ASDs, and issues related to ASDs in children are discussed separately. (See "Surgical and percutaneous closure of atrial septal defects in adults" and "Clinical manifestations and diagnosis of atrial septal defects in adults" and "Identification and assessment of atrial septal defects in adults" and "Classification of atrial septal defects (ASDs), and clinical features and diagnosis of isolated ASDs in children" and "Management and outcome of isolated atrial septal defects in children".)


Overview — Atrial septal defect (ASD) closure is indicated in the following settings:

For patients with a significant left-to-right shunt from the ASD as evidenced by right ventricular volume overload without pulmonary arterial hypertension, with or without symptoms. (See 'Right ventricular volume overload' below.)

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Literature review current through: Nov 2017. | This topic last updated: Nov 27, 2017.
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