what are the Recommendations for Atrial Septal Defect
Referenced studies that support recommendations are summarized
in Online Data Supplement 26 and the systematic review
report.S4.1.1-1?
In adults with isolated secundum ASD causing impaired functional capacity, right atrial and/or RV enlargement, and net left- to-right shunt sufficiently large to cause physiological sequelae (eg, pulmonary? systemic blood flow ratio [Qp:Qs] ?1.5:1) without cyanosis at rest or during exercise, transcatheter or surgical closure to reduce RV volume and improve exercise tolerance is recommended, provided that systolic PA pressure is less than 50% of systolic systemic pressure and pulmonary vascular resistance is less than one third of the systemic vascular resistance.S