ArticleJACC. Case reports2026
Atrial Septal Defect Closure With Persistently Elevated Pulmonary Vascular Resistance.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Risk Refinement in the "Treat-to-Repair Era".JACC. Case reports · 2026Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
clinical conditionA 32-year-old man presented with a secundum atrial septal defect (ASD) complicated by pulmonary arterial hypertension (PAH) with elevated pulmonary vascular resistance (PVR), creating a major operability dilemma. KEY QUESTIONS: What is the diagnostic work-up in suspected pulmonary hypertension? Should genetic testing be performed in congenital heart disease-associated PAH? How should ASD patients with elevated PVR be managed? Should closure be pursued despite persistent PVR elevation? What is the surgical strategy in this setting? OUTCOME: PAH-targeted therapy improved symptoms and reduced PVR, although values remained elevated. After multidisciplinary reassessment, a "treat-to-repair" strategy with fenestrated surgical closure was pursued. Despite transient postoperative right ventricular dysfunction, the patient achieved marked clinical, echocardiographic, biomarker, and hemodynamic recovery. TAKE-HOME MESSAGES: Operability in ASD-associated pulmonary hypertension requires individualized, multidisciplinary decision-making beyond fixed PVR cutoffs. Fenestrated ASD closure after targeted PAH therapy can balance shunt reduction and right ventricular protection in patients with elevated PVR.
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