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Larger ventricular septal defects do not close as the child grows. If it does not close, closing the heart surgically is necessary.

• Surgical closure is typically done before the child begins preschool.



• Surgery is indicated if medications do not work in the first few months or years of life, especially if the child is not growing adequately even with medications.



• Surgery is more urgent if evidence of pulmonary hypertension has developed.



• The most used operation involves placing a Gore-Tex patch over the hole. This prevents shunting (the movement of oxygenated blood from the left to the right ventricle).

Surgery is not usually performed in newborns because small defects will close spontaneously in 20-25%. The surgery also is more risky in the first few months of life; the risk of death from the operation is higher in the first 6 months of life than later.

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