Atrial septal defects (ASDs) represent the most common congenital heart defect diagnosed in adulthood. Although considered a simple defect, challenges in optimal diagnostic and treatment options still exist due to great heterogeneity in terms of anatomy and time-related complications primarily arrhythmias, thromboembolism, right heart failure and, in a subset of patients, pulmonary arterial hypertension (PAH). Atrial septal defects call for tertiary expertise where all options may be considered, namely catheter vs. surgical closure, consideration of pre-closure ablation for patients with atrial tachycardia and suitability for closure or/and targeted therapy for patients with PAH. This review serves to update the clinician on the latest evidence, the nuances of optimal diagnostics, treatment options, and long-term follow-up care for patients with an ASD.

中文翻译：

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成年期房间隔缺损：先天性心脏病的新范式

房间隔缺损 (ASD) 是成年期诊断出的最常见的先天性心脏缺陷。尽管被认为是一个简单的缺陷，但由于解剖结构和时间相关并发症（主要是心律失常、血栓栓塞、右心衰竭以及部分患者的肺动脉高压 (PAH) ）方面的巨大异质性，最佳诊断和治疗方案仍然存在挑战. 房间隔缺损需要三级专业知识，可以考虑所有选项，即导管与手术封堵，考虑房性心动过速患者的封堵前消融以及 PAH 患者是否适合封堵或/和靶向治疗。这篇综述旨在让临床医生了解最新证据、最佳诊断的细微差别、治疗方案、