Background : Transcatheter device closure is an effective treatment in secundum atrial septal defect (ASD). However, chronic left to right shunt which result in pulmonary hypertension, arrhythmia and heart failure often discourage treatment in elderly. As there are not many reports on the outcome of device closure in these patients. we retrospectively reviewed the outcome in our institute. Methods : From May 2003 to April 2010, 557 patients underwent successful ASD device closure in Severance Cardiovascular Hospital. Among them, 40 patients were over the age of 60. In these 40 patients, we reviewed the clinical outcome and compared the echocardiographic parameters before and after the device closure. Results : The device size was 23.8짹6mm and pulmonary to systemic flow ratio (Qp/Qs) was 2.35짹0.8. Pulmonary hypertension was evident in 18 patients (45%) prior to the device closure and 11 of them (27.5%) was normalized immediately after the closure. 12 patients (30%) showed arrhythmia before the procedure, 8 of them had persistent atrial fibrillation, and there was no change in rhythm after the procedure. 4 patients developed paroxysmal atrial fibrillation right after the device implantation, but all recovered. 19 patients had co-morbidity prior to device closure. After the procedure, cardiac geometry was remodeled. The right ventricle showed decreased volume overload and transient decrease in function but recovered. The left ventricle showed mild restrictive pattern due to volume loading, but myocardial function did not show significant change. Conclusion : Trasncatheter closure of secundum ASD is technically feasible, efficacious, and safe in elderly patients.