Radiological findings in atrial septal defect in the middle-aged

This study comprises 83 patients who underwent surgery for atrial septal defect of secundum type (ASD II) after 40 yr of age. A follow-up study was performed on average 74 mth after surgery. Before surgery enlarged heart volume was found in 72% of the patients. Increased pulmonary vascularity was the most characteristic finding (96%), followed by enlarged central hilar vessels. The heart volumes showed best correlation with the right ventricular systolic pressure, whereas correlation with the shunt ratio was much poorer. After surgery the mean heart volume was reduced by 22% in patients who were without a residual shunt. In only one of these the volume was increased. The pulmonary vascularity remained increased in 30% after surgery. In patients with a residual shunt, the frequency of still enlarged or increased heart volume, and increased pulmonary vascularity, was considerably large than in patients with completely closed ASD.