congenital heart defect

my nephew now he is 2 months old , weight=10 pounds, he has VSD peri membaranous + ASD 4mm
he is taking  lopril +  digoxin


the last echodoppler result VSD=7mm,   DAo=1,05 ( I think it is aortic dilatation, it"s writting in french)
VL 18 / 27 mm (velocity?)            ejection fraction=63%    Qp / Qs =2,3  (pulmnow   debit / systhemic debit ?)

the pediatric cardiologist said that he does not need a surgery but the surgent said 80% of chances he will be schedule for surgery when he gain more weight (16 pounds at least) what do think doctor , this contradiction is bothering me and his parents , thank you.

[Marie M Gleason, M.D.]

A 7 mm defect would be considered a large ventricular septal defect.  I am sure this is why the child was placed on cardiac medications.  A Qp:Qs ratio of 2.3 indicates a large shunt.  I do not understand the rest of the numbers you report.  The indications for surgery are elevated pressures in the lungs and/or failing to thrive.  Since the child appears to be growing the cardiologist is giving him time to prove whether or not the hole can get smaller in the next couple of months.  The surgeon is saying that this hole has a strong likelihood of needing to be fixed in the future. In this situation time, and serial assessment of the hole and the the child's growth will guide the timing for surgery.

[mshanson]

I'm not a surgeon, but a 7mm VSD in a baby that small is definitely a moderate size. How big was he when he was born? Has he been having any signs of heart failure? My daughter was born with a large VSD and a small ASD. She is having open heart surgery next week to repair both defects. She will be 4 months old, and 11 lbs.