The physiological consequences of an atrial septal defect depend on the magnitude and duration of the shunt, and on the response of the pulmonary vascular bed. 1 Pulmonary vascular occlusive disease and pulmonary arterial hypertension may then develop in adulthood.
Survival is limited in young adults who develop progressive pulmonary hypertension.
Even these patients, however, may live to reach their 40's. In their 50's, these patients experience increasingly frequent atrial arrhythmias, which represent a common precipitating cause of heart failure. 5 Cardiac surgery requires cardiopulmonary bypass equipment to achieve closure through a right atriotomy. 3 A variety of devices for transcatheter closure of ASDs have been developed in the past few decades. Until now, however, none of them have been entirely satisfactory.