Introduction: Atrial septal defect is the most frequent congenital cardiac malformaion among adults. In chil-dren and young adults with atrial septal defect the surgical correction bears an important clinical and hemodynamical benefit, at a low surgical risk. The be-nefit of the surgical correction after the age of 40 still remains a great dilemma and represents a subject of debate among surgeons and cardiologists.

Methods: We are presenting the case of a 47-year-old patient diagnosed with ostium secundum atrial septal defect, surgically corrected at the age of 44 with a pe-ricardium patch. Preoperative the right cavities of the heart were dilated, with important systolic disfunction of the right ventricle, tricuspid regurgitation and se-condary moderated pulmonary hipertension. Results: T he clinical and paraclinical evaluation, 3 years after the procedure, highlights the improvement of the symptoms (fatigue), the persistency of others (palpitations) and the partial mend of echocardiogra-phic changes (despite the good functionality of the pe-ricardium patch and the lack of a remaining commu-nication). Furthermore is presented the clinical and paraclinical evaluation of this patient at 1 and 3 years after the surgery. The results are going to be compared with the ones found in the literature.

Conclusions: In conclusion, the postoperative evoluti-on of a patient with atrial septal defect depends mostly on his age, the greater benefit, both clinical and paracli-nical, being found in patients with correction procedu-res at young ages.