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Therefore, a large left-to-right shunt through a patent ductus arteriosus (PDA) results in left atrial and left ventricular enlargement. The pulmonary veins and the ascending aorta can also be dilated with a sufficiently large patent ductus arteriosus (PDA).
In atrial septal defect, shunting is left to right initially (see Figure: Atrial septal defect.). Some small ASDs, often just a stretched patent foramen ovale, close spontaneously during the first few years of life. Persistent moderate-to-large ASDs result in large shunts, leading to right atrial and right ventricular volume overload.