29
4.1.1. Atrial Septal Defect
COR LOE
Recommendations
2b B-NR
10. In adults with an unrepaired ASD and PAH for whom
closure is indicated, fenestrated repair can be considered to
improve functional class and clinical outcomes.
2b B-NR
11. In adults with unrepaired superior sinus venosus ASD (SVASD),
transcatheter closure (when technically feasible) may be a
reasonable alternative to surgery to reduce operative morbidity.
2b B-NR
12. In adults with an unrepaired ASD, significant left-to-right
shunt (Qp:Qs ≥1.5), and PAH with PVR of 5 to 8 Wood
units while receiving targeted PAH therapy, the usefulness
of fenestrated ASD closure to improve functional class and
clinical outcomes is uncertain.
3: Harm C-LD
13. In adults with an unrepaired ASD and Eisenmenger
physiolog y, ASD closure should not be performed to avoid
increasing morbidity and mortality.
* Significant le ventricular disease: any condition resulting in chronically elevated le atrial
pressure ≥15 mm Hg.
(cont'd)
