The timing of surgical or trans-catheter intellrention for congenital heart disease(CHD) is a critical decision and one of the most important tasks the pediatric cardiologist is asked to perform. Simply stated, the decision about when to intervene requires carefully balancing the results of the procedure with the natural history of the conditions.
Spontaneous Closure of Defects
Some defects have a tendency towards spontaneous closure and this can influence the timing of intervention. The defects known to close spontaneously are atrial and ventricular septa1 defects and during the first few weeks of life, patent arterial duck. The variables that influence likelihood of spontaneous closure include, age at evaluation (the likelihood of spontaneous closure declines with age and most ASDs and many VSDs are unlikely to close after the first three yeas of age), size of the defect (smaller defects are more likely to close),location of the defects (fossa ovalis ASDs, peiimembranous and muscular VSDs can close on their own).
Spontaneous Closure of Defects
Some defects have a tendency towards spontaneous closure and this can influence the timing of intervention. The defects known to close spontaneously are atrial and ventricular septa1 defects and during the first few weeks of life, patent arterial duck. The variables that influence likelihood of spontaneous closure include, age at evaluation (the likelihood of spontaneous closure declines with age and most ASDs and many VSDs are unlikely to close after the first three yeas of age), size of the defect (smaller defects are more likely to close),location of the defects (fossa ovalis ASDs, peiimembranous and muscular VSDs can close on their own).
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