In cardiac surgery, the perioperative mortality rate of secondary foramen ovale septal defect is low. However, all of these elderly patients have a combination of varying degrees of cardiopulmonary impairment, atrioventricular valve impairment, and atrial arrhythmias due to prolonged left-to-right shunting at the atrial level. Due to the impaired function of other organs in the body, there are obvious special features in their surgical methods and perioperative management. 1.Surgical method All patients in the group were operated under extracorporeal circulation with a median chest incision. The mitral valve and tricuspid valve were routinely explored during the operation, and the tricuspid valve was De Vage formed in 11 cases and Duran annuloplasty in 6 cases; coronary artery bypass grafting was performed in 3 cases at the same time; radiofrequency ablation (Medtronic defibrillation pen) was performed in 6 cases at the same time, and pacing wires were routinely left on the right ventricular surface during the operation. 2. Postoperative treatment Postoperative ventilator-assisted breathing overnight, routine application of dobutamine 3~5μg/kg.min, appropriate application of sodium nitroprusside and nitroglycerin, postoperative routine application of ethidium iodophor in RF ablation patients. Oral medications were routinely applied digoxin, dihydrocollidine, and potassium slow release for 3~6 months.