The natural history of a ventricular septal defect (VSD) that size is for it to stay the same size or to get smaller. Sometimes, they even close. However, it sounds like your daughter's defect has not closed. That said, it sounds as if she is growing well and is active, suggesting that the defect is small and not causing a problem. Without seeing her, I cannot say if it will close, or not. However, I can say that there are plenty of children who grow up and have small VSDs remain open--they do not cause problems. The only time that it can cause a problem is if the VSD is just beneath the aortic valve, as a "perimembranous" VSD. These can occasionally cause deformation of the aortic valve, causing them to prolapse or to leak. Thus, these require continued observation to ensure that this is not progressing.
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