Hi Mr Acharaya, There is consensus among cardiologists that operable ASD (meaning thereby pulmonary pressure still below systemic pressure- with left to right shunt) of any size should be closed because normal age related diseases like hypertension, coronary artery disease and heart attack have worse consequences in an ASD which is still not closed. I assume you wife has systemic hypertension this will increase left to right shunt in an open ASD and can lead to heart failure. If echocardiography (which has apparently not been done) shows appropriate size and appropriate rim around the atrial septal defect is amenable to device closure then that procedure is highly recommended. Because the device closure is done under local anesthesia, it does not involve more than what is percutaneously done in Coronary Angiography. Chest is not opened it is a closed procedure which takes about an hour. I would urge to consult your cardiologist. Coming to your question, in hypertension there is no drug of choice but choice of drugs which depend on what an individual physician chooses for a particular patient. Best Wishes Anil Grover Cardiologist