Q: My 32 days old son has been detected with a ventricular septal defect (VSD) with left to right flow. The interactive visualisation system (IVS) shows drop out echoes in the membranous portion (2.6 mm diameter) with peak gradient of 60 mmHg. The doctor did not advise any medications or treatment and asked us to wait till 3-4 years. What are the chances of this defect healing on its own?

A:This is a small VSD and therefore requires no immediate treatment. Our protocol would be to follow up now at 3 months and later at 6 months to yearly interval till the child is 3-4 years. If the defect remains as such we can extend the frequency of follow ups. A VSD will never enlarge in size but there are instances when even a small VSD may require closure and that will be known only when we have a close follow up at least till adolescence. Nobody can predict when or if a VSD will close except that 25-30% of small VSD do close early in life.