Clinical and Hemodynamic Profile of Patients Undergoing Early Closure of Atrial Septal Defect: A Systematic Review and Pooled Analysis.

Atrial septal defect (ASD) is considered a benign condition and is usually closed electively in pre-school age. Early symptomatic presentation is uncommon and often associated with comorbidities such as chronic lung disease and recurrent respiratory infections. Although pulmonary hypertension is rare in ASD, infants with large defects may develop respiratory symptoms and failure to thrive even in its absence. In such conditions earlier intervention may be considered, particularly in those with right heart volume overload or growth impairment. However, limited evidence suggests potential benefit from early intervention, especially in infants with bronchopulmonary dysplasia. This study aims to systematically review the literature and perform a pooled analysis of clinical and hemodynamic characteristics of children undergoing early ASD closure (weight < 15 kg or age < 2 years). Additionally, it evaluates the safety and efficacy of both surgical and transcatheter closure in this population.