Motivated by esthetic considerations, the authors undertook surgical cure of atrial septal defects by a right antero-lateral thoracotomy in 80 patients with an average age of 24 +/- 13 years (range: 12-62 years) between 1984 and 1994. The pathologies operated were ostium secundum (62), superior sinus venosus defects (12), low atrial septal defects (2) and ostium primum lesions forming partial atrioventricular canals (4). Mortality rate was nil. The esthetic result was satisfactory overall. The authors suggest that a right antero-lateral thoracotomy provides an esthetic result whilst respecting the essential factor of maximal security.