There is little argument over the advisability of surgical closure of atrial septal defects in children. If not treated surgically, many patients survive to adulthood, some even to advanced years, though the average life-span is reduced.1-4 Pulmonary hypertension may develop at any age, worsening the prognosis for untreated patients and raising the risks of operative treatment. Even with these disadvantages, certain recent reports5-7 present a favorable view of operative treatment for atrial septal defects in adults or even in elderly patients.8 However, Beck et al9 have pointed out the lack of symptomatic improvement in certain patients despite successful survival after operative treatment. We are reporting our experience with 56 patients, 16 years of age or older, who have had closure of atrial septal defects during the period from 1956 to 1969.
From a total of 196 consecutive patients who had closure of secundum-type atrial