is a ostium primum self correccting?

My daughter was born 8 weeks early and at about 3 weeks old, GA about 35 weeks, she underwent an cardiac echo for frequent episodes of bradycardia during feeding.  At that time she was diagnosed with a ostium primum, according ro her medical records although I don't remember the doctor using those words (she mostly talked about a hole in her heartremaining from fetal cardiac anatomy).  I was told that most of the premies in the nursery probably had the same defect and it would probably correct itself. Once I read the diagnosis I did some research everything indicated that ostium secondum might self correct but not ostium primum.  What am I missing?  At 5 months old she had an ECG which was "normal" -whatever that means- and presents no systems that I know of.  The pediatric cardiologist that I saw didn't think that her condition warranted a second echo because, she said, at her age that would involve sedating her.  Her next appointment is at age 18 months.  I've read differing opinions on when to take corrective measures if they're necessary.  What should I be doing for her?

[Jeffrey R Boris, M.D.]

Dear Rose,

What you post and what you were told do not coincide.  You ask about an ostium primum defect, with is one of the types of holes in the septum between the upper two chambers of the heart.  These do not spontaneously close, and typically require surgical repair.  However, what you describe as being told sounds more like a foramen ovale, which is a flap valve that all babies have in utero.  It typically closes some time before the first year, although 25% of all adults have it open.  Therefore, it is difficult for me to know what your daughter has, and without seeing her, I cannot answer your question with regards to her specific needs.  The good news is that if it is either, the primum defect is usually closed some time before age 3-5 years, so as long as she is not having symptoms of exercise intolerance, getting out of breath sooner than other kids, or sweating with activity before other kids, nothing needs to be done at this point until her follow-up.  It does sound like you need to talk with your cardiologist to get further clarification of what your daughter's situation is.