31
PVR ≤2 WU
PVR >2 to <5 WU
PVR 5–8 WU that
decreases to <5 WU on
PAH therapy
PVR 5–8 WU on PAH
therapy
2b
Expert PAH and
ACHD care;
possible closure
1
ASD closure
2a
ASD closure
2a
ASD closure
Avoid ASD closure
3: Harm
* Therapy, PAH-directed medical therapy.
All ASD closure recommendations assume the patient has no evidence of significant left heart
disease.
ACHD indicates adult congenital heart disease; ASD, atrial septal defect; PAH, pulmonary arterial
hypertension; PH, pulmonary hypertension; PVR, pulmonary vascular resistance; Qp:Qs, pulmonary-
to-systemic blood flow ratio; RV, right ventricle; and WU, Wood units.
