Atrial septal defect is a simple congenital heart disease, but the treatment of adult atrial defect has its own characteristics and is worth discussing: first of all, adult patients have been suffering from the disease for a long time, and combined with our own experience, the postoperative circulatory status of patients younger than 30 years old is mostly stable, while patients over 40 years old tend to have smaller left ventricular development and high pulmonary artery pressure due to the long duration of the defect. The treatment of these patients should pay special attention to the intraoperative and postoperative rhythm problems, and it is best to routinely place temporary pacing leads intraoperatively; and the postoperative volume control should be stricter, and water intake must be restricted in the early postoperative period; secondly, for atrial defects with high location, such as superior chamber type or atrial defects with very high upper part of the defect, air embolism is likely to occur intraoperatively and postoperatively, and the manifestation of air embolism varies, with myocardial ischemia being the main one. The manifestations of air embolism are different, such as myocardial ischemia and ST-segment elevation, which can be relieved by intravenous nitroglycerin pumping; for arrhythmia, there is the possibility of right coronary micro-embolism and myocardial intolerance, and nitroglycerin can be applied with lidocaine, amiodarone and other antiarrhythmic drugs; for cerebrovascular embolism, there is transient blindness, transient aphasia and transient loss of consciousness. Third, patients with suspicious preoperative coronary angiograms should be very cautiously prepared in accordance with preoperative coronary surgery and timely coronary artery bypass surgery if necessary, as well as intraoperative implantation of IABP. Fourth, the chances of pericardial effusion in adults after atrial defect are high, patients must be informed before surgery and insist on monthly ultrasound review for 3 consecutive months even after discharge. If the patient does have a large amount of pericardial effusion, we can consider first pericardial puncture and drainage, and then weekly ultrasound follow-up for 4 weeks, followed by monthly ultrasound for 3 months; in some patients, the pericardial effusion is located in the posterior and both sides of the pericardium, and the risk of pericardial puncture and drainage is high, or the pericardial effusion is repeatedly produced in the repeatedly punctured area. The lower end of the original incision to release fluid. However, because the patient’s heart is compressed by pericardial effusion for different lengths of time, the patient’s cardiac function is also significantly affected. Fifth, the treatment of tricuspid regurgitation, there is a view that if the tricuspid valve leaflet development is normal leaflet closure is still possible, even if the annulus is slightly large, preoperative presence of a small to moderate amount of regurgitation does not require surgical intervention, pending its natural recovery; personally, I believe that for patients with significant preoperative annular enlargement and tricuspid regurgitation of moderate degree or more as reported by ultrasound, routine tricuspid annulus reduction shaping.