Methods: Between May 1999-December 2004, fifty two patients (17 males, 35 females; mean age 41.6±7.7; range 35 to 65 years) aged ≥35 years, underwent surgery for atrial septal defect (ASD). The diagnosis was made by echocardiography in all patients. The ASD types were as follows: 41 fossa ovalis type ASD, 4 Superior Sinus Venosus ASD+PAPVD anomaly, 7 IVC type ASD. Two patients had additional tricuspid insufficiency. Mean preoperative left to right shunt was 2.6±0.7.

Results: ASD was closed primarily in 36 patients and with a patch in 16 patients. Patch material was pericardium fixed in glutaraldehyde in 15 patients and extented- PolyTetraFluoroEthylene (ePTFE) in 1 patient. No mortality was observed in early postoperative period. Two patients were readmitted to the operating room for bleeding and cardiac tamponade.

Conclusion: Atrial septal defects should be closed to prevent late cardiac rhythm problems, cardiac failure and paradoxical embolic events even as late as 35 years of age or more. ASD closure is a standart procedure and can be performed with low mortality and morbidity even during advanced age.