Q: My brother is 32 years old. He has a hole in his heart. Is it serious? Can it be operated safely? What are the risk factors, if any?

A:Hole in the heart could be of various kinds. One in the upper chamber of the heart, called atrial septal defect (ASD), is a very simple and relatively safe disease but the one in the lower chamber of the heart, called ventricular septal defect (VSD), is little more problematical if not closed. The holes can be closed either by an open-heart surgery or by deployment of a device non-operatively (percutaneously). The main risk factor, which leads to undesirable side effects, is the high pressure in the lungs, which sometimes-longstanding holes in the heart can lead to (called Pulmonary Arterial Hypertension). Operations are generally safe (risk less than 1%), unless pressures in the lung are very high and heart has gone into failure. As your brother is 32 years old, he could well have it and therefore I suggest you to contact your Cardiologist who would take a final decision for him.