Key result
Personalized risk stratification should guide adult ASD management over universal closure.
Why the study?
Adult ASD management requires risk-based decision-making rather than a one-size-fits-all closure approach to establish personalized treatment pathways.
Adult ASD management should transition from universal closure to personalized, risk-stratified treatment pathways within specialized adult congenital heart disease programs.
Shifts adult ASD care to personalized risk-stratified pathways in ACHD programs; challenges universal closure and extends specialized program referral.
Risk-based decision-making should be central to adult ASD management, integrating age, atrial arrhythmia burden, right ventricular (RV) remodeling, pulmonary vascular disease, and comorbidities This review translates existing evidence into a practical decision-oriented framework. Future strategies should move away from a 'one-size-fits-all' closure approach toward personalized treatment pathways within specialized adult congenital heart disease (ACHD) programs.
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Si̇nan et al. (2026) studied this question. Personalized risk stratification integrating age, arrhythmias, right ventricular remodeling, and comorbidities should guide adult atrial septal defect management rather than universal closure.
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