Treatment of Atrial Septal Defect with Pulmonary Vascular Resistance ≥5 WU

Atrial septal defect (ASD) in the presence of pulmonary vascular resistance (PVR) at or above 5 Wood units defines a distinct clinical subset. Elevated PVR at this threshold affects the safety and timing of closure, requiring a specific, staged approach before any definitive intervention.

Clinical scenario: This protocol applies to patients with ASD in whom measured pulmonary vascular resistance is ≥5 WU — a level at which standard closure is not immediately appropriate and targeted haemodynamic optimisation must precede any definitive decision.

Approach

Under specific haemodynamic conditions achieved following targeted pulmonary arterial treatment, a modified closure strategy may be considered — the complete eligibility criteria, procedural approach, and full structured protocol are available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/eurheartj/ehaa554
In patients with PVR ≥5 WU, fenestrated ASD closure may be considered when PVR falls below 5 WU after targeted PAH treatment and significant LR shunt is present (Qp:Qs >1.5).

View source ↗