Atrial Septal Defect with Suspicion of Paradoxical Embolism — Other Causes Excluded, No PAH, No LV Disease
This protocol addresses atrial septal defect (ASD) in patients where paradoxical embolism is suspected, all other embolic causes have been excluded, and there is confirmed absence of pulmonary arterial hypertension and left ventricular disease — a clinically distinct scenario that determines the management approach.
Clinical Scenario
Suspicion of paradoxical embolism with other causes excluded; confirmed absence of pulmonary arterial hypertension and absence of left ventricular disease. This profile identifies a subset of ASD patients in whom the indication for intervention is driven by the embolic risk rather than haemodynamic burden alone.
Approach (Partial Overview)
Current evidence supports a structural approach to the defect itself in this setting — independent of defect size. The full protocol specifies the intervention pathway, patient selection criteria, and procedural considerations.
References
DOI: 10.1093/eurheartj/ehaa554
In patients with suspicion of paradoxical embolism (exclusion of other causes), ASD closure should be considered regardless of size providing there is absence of PAH and LV disease.
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