[Atrial septal defect type ostium secundum at the age of 40 or more. Apropos of 86 cases with hemodynamic exploration].

The authors propose a haemodynamic classification for ASD, taking into account the very frequent drop in systemic blood pressure which is observed in this disease in elderly people. The authors examine the clinical signs and the clinical course in terms of this haemodynamic classification and they stress the mitral abnormalities and the arrhythmias. 56% of patients were followed up for a mean of 6 years for non-operated patients and almost 10 years for operated patients. The pathophysiology of ASD is discussed. It appears to be very dependent on left ventricular function. The operation needs to be discussed in terms of the haemodynamic findings, even in elderly subjects and in almost asymptomatic subjects.