Objective To report 49 cases of adult interatrial septal defect with pulmonary hypertension operated and to evaluate their results.Method Most of those cases were repaired with conventional operative procedures,but 2 cases among them with severe pulmonary hypertension were repaired with one-way valvular patch.Those with mitral or tricuspid remarkable regurgitation,were repaired with annuloplastic procedure at the same time.Results There were no operative death,and followed up for one to five months,the heart size,ECG and the data of blood gas analysis were retuned into normal value.Heart function of 47 case was raised to Ⅰ class(NYHA),and 2 case to Ⅱ class.Conclusions Operation for adult interatrial septal defect especially with pulmonary hyperteasion is highly indicated.Treatment of mitral or tricuspid regurgitation remarkably at the same time is important for recovery of cardiac function.One-way valvular patch used to repair ASD with severe pulmonary hypertension could reduce complication and mortality,so it is an effective procedure adapted.