Atrial heart defect surgery can be done at age 45 as long as the criteria for surgery are met. Age is not a major factor in determining atrial septal defect surgery, so atrial septal defects can be treated surgically at 45 years of age as long as they meet the criteria for surgery, noting that the surgery will also need to be based on the presence or absence of other factors such as arrhythmia and heart failure. For adults, surgery is needed as soon as possible if the atrial septum is more than 5mm. For patients with other comorbidities, such as heart failure, the first step should be to actively control heart failure before surgery, while for patients with pulmonary hypertension, right-to-left shunt and cyanosis, it is not possible to perform atrial septal defect surgery. Whether 45-year-old cardiac atrial septal defect can be operated, need to promptly seek medical examination, the doctor according to the actual situation to determine whether the operation can be operated.