Results of surgery for atrial septal defect in patients of 40 years and over.

Surgical closure of an atrial septal defect was performed on 104 patients over the age of 40 at the Brompton Hospital. The hospital mortality was 9·6%, reducing to 2·7% in the last six years. There were five late deaths. A moderate increase in preoperative pulmonary artery systolic pressure did not influence mortality. Twenty-five per cent of patients in preoperative atrial fibrillation have been maintained in sinus rhythm an average of five years following operation. Seven per cent of patients in sinus rhythm preoperatively left hospital in atrial fibrillation. Another 7% developed atrial fibrillation an average of seven years after operation. At late follow-up 75 patients were symptom-free and leading normal lives. It is concluded that patients in this age group with atrial septal defect benefit from surgical closure of the defect.