Q: My 65 years old father has recently been diagnosed with a hole in his heart after an echo test. Further, we did a transoesophageal echocardiography (TOE) test, which confirmed an ASD of 17 mm. He has been healthy and active all his life. So, should we go for surgery to close the hole or should we wait for other symptoms?

A:I think if your father is totally symptom free and if the hole in the heart was detected accidentally, then I see no reason why this hole should be closed. Lot of people with holes in the heart live through a completely normal life span without ever coming to know of the hole. I definitely do not intend to suggest that a hole in the heart is without any risk whatsoever, but the risk of hole creating a problem at the age of 65, I feel is less than the risk of surgery, in case the patient has no symptoms whatsoever and if the pressures of the lungs (PA pressure) are normal. However, I would suggest that you take a cardiologist’s opinion also by direct consultation because some times you may not be able to convey certain findings or symptoms, which a cardiologist may be able to detect and which may have a bearing on the decision making process.