Lessons from cardiopulmonary testing after device closure of secundum atrial septal defects: a tale of two ventricles.

here has been much controversy during the past 50 years s to which patients with secundum atrial septal defects ASDs) should have them repaired. Because there was little vidence to support a mortality benefit, a morbidity advanage, or a clear and objective functional improvement after urgical closure, many physicians and patients waited until ymptoms developed before seeking the surgeon’s help. uch reluctance was reinforced by the necessary conseuences of surgical ASD repair—an incision and a scar, a eriod of pain and discomfort, the need for convalescence, nd exposure to cardiopulmonary bypass. The fact that 75% f ASD patients were female made it even more common ot to recommend surgery for asymptomatic patients.