Season 4 - Ep3: Atrial septal defects in adults - Conservative and invasive management of chronic coronary syndromes

27 snips

Feb 19, 2026

Guest

Rasha Al-Lamee

Guest

Roxana Mehran

Guest

Annemien van den Bosch

Guest

JP Carpenter

Rasha Al-Lamee, interventional cardiologist researching angina and PCI. Roxana Mehran, expert in coronary revascularization. Annemien van den Bosch, adult congenital cardiologist focusing on atrial septal defects. JP Carpenter, cardiology commentator with study highlights. They discuss atrial septal defect diagnosis and closure strategies. They debate conservative versus invasive care for chronic coronary syndromes and review recent cardiovascular study headlines.

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ADVICE

Manage High PVR Before Closure

If pulmonary vascular resistance (PVR) exceeds ~5 Wood units, ASD closure is contraindicated; treat with PAH therapies first.
Reassess after pulmonary vasodilator therapy to see if PVR falls and closure becomes feasible.

ADVICE

Choose Closure Method By Defect Type

Choose percutaneous closure for secundum ASDs with adequate rims and safe location near structures.
Use surgical repair for primum or sinus venosus defects not amenable to device closure.

INSIGHT

AF Remains A Problem Post-Closure

Atrial fibrillation and other atrial tachycardias affect roughly 20% of adults with ASD and persist after closure.
Closure can complicate later ablation because devices make transseptal access more challenging.

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This episode covers:

Cardiology This Week: A concise summary of recent studies

Atrial septal defects in adults

Conservative and invasive management of chronic coronary syndromes

Milestones: 4S trial

Host: Rick Grobbee

Guests: JP Carpenter, Annemien van den Bosch, Rasha Al-Lamee, Roxana Mehran

Want to watch the episode? Go to: https://esc365.escardio.org/event/2552

Want to watch the extended interview on Atrial septal defects in adults, go to: https://esc365.escardio.org/event/2552?resource=interview

Disclaimer:

ESC TV Today is supported by Novartis through an independent funding. The programme has not been influenced in any way by its funding partner.

This programme is intended for health care professionals only and is to be used for educational purposes.

The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode.

The ESC is not liable for any translated content of this video. The English language always prevails.

Declarations of interests:

Stephan Achenbach, Yasmina Bououdina, Rick Grobbee, Nicolle Kraenkel and Annemien van den Bosch have declared to have no potential conflicts of interest to report.

Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede.

Rasha Al-Lamee has declared to have potential conflicts of interest to report:speaker's fees for Menarini pharmaceuticals, Abbott, Philips, Medtronic, Servier, Shockwave, Elixir. Advisory board: Janssen Pharmaceuticals, Abbott, Philips, Shockwave, CathWorks, Elixir, Astrazeneca. Consulting Fees: Menarini pharmaceuticals, Abbott, Philips, Shockwave, Elixir, IsomAB, VahatiCor, SpectraWave, AstraZeneca, Cathworks, Janssen Pharmaceuticals.

John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI.

Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo.

Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.

Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck.

Roxana Mehran has declared to have potential conflicts of interest to report: institutional research payments from Abbott, Alleviant Medical, Chiesi, Concept Medical, Cordis, CPC Clinical Research, Daiichi Sankyo, Duke, Faraday Pharmaceuticals, Idorsia Pharmaceuticals, Janssen, MedAlliance, Medtronic, NewAmsterdam Pharma, Novartis, Novo Nordisk Inc., Population Health Research Institute (PHRI), Protembis GmbH, Radcliffe, RM Global Bioaccess Fund Management, Sanofi US Services, Inc. ; personal fees from: None ; Equity

Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.

Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson