Atrial septal defect closure with left ventricular dysfunction.

Atrial septal defects are one of the most common congenital heart diseases in adults that may result in significant left to right shunt. Secundum atrial septal defects can remain unrecognised until adult age and cause haemodynamic changes with or without symptoms. Transcatheter ASD closure is the gold standard; however, in those patients with left ventricular dysfunction there may be increased risk of complications due to acute changes in left-sided pressures. In this review, we discuss the clinical aspects of ASD closure in the setting of LV dysfunction and discuss methods to evaluate risk and strategies to minimise complications.