What should parents do when they find out that their child has ventricular defect with aortic valve insufficiency? From the pathogenesis, ventricular defect combined with aortic valve insufficiency is impossible to heal by itself. If left unattended for a long time, secondary changes will occur in the aortic valve, such as leaflet thickening and contracture, and the problem of aortic valve insufficiency will become more and more serious, and the surgical result will be worse and worse. Some parents will say, the size of the child’s ventricular defect was 8 mm at the beginning, and then it became 6 mm, doesn’t this mean that the septal gap is shrinking? Why must surgery be performed? In fact, it is likely that after the ventricular defect causes the aortic valve to close incompletely, the valve prolapses to cover part of the ventricular defect, resulting in a reduction of the effective blood shunt area, which is not a sign of self-healing ventricular defect, but a sign of aggravation of the aortic valve condition. In this case, it is sometimes difficult to distinguish on echocardiography, so it gives the illusion that the ventricular defect has shrunk. Parents should not take this condition lightly, and it is best to go to a major heart center for further evaluation to accurately determine the severity of the child’s condition. What is the best age for the child to have surgery? If the ventricular defect is not too large and is not combined with aortic valve insufficiency, surgery can usually be performed around the age of 1 year; for some special ventricular defects (e.g., inferior stem type, internal crest type), it is best to operate within 6 to 12 months after birth because these children are prone to combined aortic valve insufficiency. If a child with ventricular defect already has combined aortic valve insufficiency, early surgery is recommended after detection. This is because aortic valve insufficiency is progressively worse as soon as it appears, and as the aortic valve develops secondary changes with age, then the treatment will not be ideal. I want to take my child for surgery, what preoperative tests should I do? The most important preoperative tests are an echocardiogram, an electrocardiogram and a chest radiograph. It is best for parents to take their child to a larger heart center for a detailed evaluation to determine the location and size of the ventricular defect, the presence or absence of aortic valve prolapse, and the degree of regurgitation. Can interventional blocking be done in these children? Interventional occlusion is generally not recommended for ventricular septal defects because the catheter and blocker are delivered during the procedure and can easily damage important tissues around the ventricular defect such as valves, conduction bundles and tendons. If the child already has aortic valve insufficiency, interventional occlusion is not suitable to avoid damaging the aortic valve and bringing more serious consequences. Is there a less invasive way to open the chest? Most children can use a small incision in the right axilla, which is about 6-8 cm long, hidden, less traumatic and less bleeding, and is a minimally invasive procedure. During the procedure, we repair the ventricular defect and fill and support the subaortic structures to stop the progression of the aortic valve. Can all children have right-sided mini-incision surgery? No. If a child presents with moderate to severe aortic valve insufficiency or severe aortic valve prolapse, intraoperative aortic valvuloplasty may be required and cannot be accomplished through a small right-sided incision, so a good preoperative evaluation is important to choose the right surgical approach.