Opinion on what to expect ASD VSD

[PoppieMae]

My daughters last echo report is as follows (taken at 5 weeks old) and we are due for another in 2 weeks before meeting with surgeon for first time. Do you think the surgeon will suggest surgery if echo shows no change?
Report-
-Moderate subaortic VSD and very small muscular VSD with moderate combined left to right shunt
-small secundum ASD with small left to right shunt
-normal ventricular function and sizes
-no evidence of volume overload or pulmonary hypertension  
-mild left pulmonary artery stenosis

My daughter does not like feeding (she is bottle fed), little interest and drinks much less than she should. She is on lisonpril and frumaside. Just recently she has begun becoming breathless when feeding/often stopping to rest. Putting on weight has been a slow process (has put on 2kg since beginning medications 15 weeks a go).
Many thanks

[PoppieMae]

Weekly weigh in yesterday showed my daughter has lost weight for the first time since starting medication-fingers crossed its a one off! Thank you so much for your information. I feel much more prepared for the appointment.

[Marie M Gleason, M.D.]

It sounds like your child is at least 4 months old now.  The decision to perform heart surgery for VSD is related to several issues:  the most important of which is whether or not there is pulmonary hypertension (the last echo report said NO) and what clinical symptoms the child has.  If there is true poor growth and feeding that can only be related to the VSD, then surgery may be recommended.  If the growth curve is adequate they may recommend watching to see if nature can make the VSD smaller over time.  So it will all depend upon the child's physical exam and growth curve at the next visit.  it could go either way.  Good luck.