Currently, ventricular septal defect is the most common condition in cardiac surgery for congenital heart disease. Patients, their families, and some doctors have many misunderstandings about this disease. The problems often encountered in clinical work are summarized as follows: 1. The self-healing problem of ventricular septal defect: ventricular septal defect is divided into sub-stem defect, intra-crestal defect, subcrestal defect, membrane defect and muscle defect according to the location of the defect. In general, septal defects that heal spontaneously are limited to membranous, small, fractional flow defects. Self-healing is achieved by covering the defect with the surrounding tricuspid septal tissue, causing the intracardiac shunt to disappear. Defects in other areas are generally rarely self-healing. 2. How large a ventricular septal defect requires surgery: The decision to operate cannot be based on ultrasound diagnosis alone. The decision should also be based on the size of the patient’s murmur, the presence or absence of tremor, the size of the atria, the increase in pulmonary blood in the chest radiograph, and the degree of electrocardiographic changes. This will partially circumvent the instability of the ultrasound diagnosis. The site of the defect is also important. We advocate prompt surgery for subcristal ventricular septal defects, even though they are small. A large proportion of patients in this part of the disease are accompanied by prolapse of the right coronary valve of the aorta, which obscures part of the ventricular septal defect, so that the ventricular septal defect found during ultrasonography is smaller than the real ventricular septal defect, and the chest radiograph and electrocardiogram cannot reflect the real situation, thus misjudging and delaying the operation, resulting in aortic valve prolapse or incomplete closure. 3, small ventricular septal defect without surgery what is the danger: one is the possibility of causing endocarditis. This possibility is very small, but once it occurs, it requires a great cost, and the patient lives nine lives. Secondly, social problems, further education, and medical examination for employment will encounter some difficulties. Third, the inner confusion of patients and their families. 4, the timing of surgery for ventricular septal defect: a truly professional doctor, can not give an optimal age for surgery. In some patients, surgery is needed within the first three months of life, and some patients may not have surgery for the rest of their lives. If the patient has difficulty feeding after birth and has recurrent pneumonia and heart failure, surgery is needed as early as possible, regardless of age. In the absence of these conditions, the fractional flow is higher and surgery is best around 1 year of age. It is important to note that some hospitals in some areas are not equipped to do surgery for younger patients, allowing patients to grow up to be 3 to 5 years old before surgery. Some patients can wait until that time, and some patients thus lose the chance of surgical cure or bring more risks to surgical treatment. 5, the problem of ventricular septal defect Chinese medicine treatment: Chinese medicine may be helpful to improve the body resistance and reduce the occurrence of pneumonia, but it does not have any significance to the ventricular septal defect itself. 6. Problems with surgery for ventricular septal defect: First, high degree of atrioventricular block, which will often require installation of a permanent pacemaker. Second, damage to the aortic valve, which requires reoperation to repair the aortic valve. Third, residual leaks, small residual leaks that may not need to be addressed, and large, multiple leaks that require reoperative repair. Fourth, combined malformations that were not detected preoperatively, such as combined right ventricular outflow tract stenosis, combined left ventricular outflow tract stenosis, etc., need to be decided based on the damage these malformations are causing to the patient’s heart. Although ventricular septal defect is a common procedure in cardiac surgery, it is not as simple as one might think. Some of the procedures are much more difficult than valve replacement and bypass. Doctors and families should not take this lightly.