congenital opening in the partition between the two upper chambers (atria) of the heart. The most common atrial septal defect is persistence of the foramen ovale, an opening in this partition that is normal before birth and that normally closes at birth or shortly thereafter. The opening in the atrial septum results in the flow of blood from the left atrium to the right, causing enlargement of the right atrium and ventricle and of the main pulmonary artery. The usual treatment, the surgical closure of the defect, is sometimes made hazardous by serious disease of the pulmonary vessels.