ESC TV Today – Your Cardiovascular News Season 4 - Ep3: Extended interview on Atrial septal defects in adults
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Feb 19, 2026 Annemien van den Bosch, adult congenital heart disease specialist at Erasmus MC, discusses atrial septal defect imaging and management. She covers multimodality imaging choices. She outlines when surgery or device closure is preferred. She highlights lifelong specialised follow-up, pregnancy counselling, paradoxical embolism indications, and emerging bioresorbable and minimally invasive approaches.
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CMR Is Essential When Echo Falls Short
- Echocardiography is first-line but often insufficient to fully define ASD anatomy and pulmonary venous return.
- Cardiac MRI is the gold standard for volumes, function and shunt quantification when echo is limited.
Evaluate Elderly Patients Before Closing
- Carefully weigh risks and benefits of ASD closure in elderly patients with comorbidities.
- Assess for left ventricular diastolic dysfunction because closure can precipitate pulmonary edema from raised left-sided pressures.
Select Closure Method By Size And Rims
- Choose percutaneous closure for secundum ASDs ≤ ~38 mm with adequate surrounding rims.
- Prefer surgery when rims are deficient, ASD is very large, or risk of device embolization or erosion is high.