Comparison of recent clinical trials of adult atrial septal defect (ASD) management
| Paper | Symptoms (%) | Age (years) | Follow up (years) | Lost to follow up (%) | Comments | Conclusion |
| Murphy et al19904 | 75 | All ages | 27–32 | 1 | Only 123 patients, about 31 over age 40; intake 1956-60; stroke deaths in patients not on coumadin | Repair ASDs before age 25; in older patients, premature death, heart failure, stroke, and atrial fibrillation were common |
| Shah et al19945 | Few | > 25 | 25 | 22 | Extremely low mortality (1/82); intake 1955-1970 (approx) | Medical and surgical outcomes equivalent; major pulmonary hypertension not seen |
| Konstantinides et al19956 | 94 | > 40 | 8 | 0 | 179 patients; surgical patients younger; 17 crossed over to surgery; intake 1966-91; excluded coronary disease and severe mitral regurgitation | Surgical repair of an ASD in the over 40 patient is better than medical treatment re survival and heart failure, although arrhythmias are a problem in both groups |