Congenital atrial septal defect repair is safe and effective in patients of
almost any age. Long-term survival among adults is excellent, although chi
ldren generally appear to fare even better. Our 25-year study of outcomes a
mong adults who underwent suture or patch closure found that survival excee
ded 90%, We discuss our observations on use of transesophageal echocardiogr
aphy, indications for cardiac catheterization, and continuing questions abo
ut atrial septal defect in adults.