Ventricular septal defect (VSD) is the most common of all congenital heart defects and can occur alone or in association with other cardiac malformations. The severity of the condition is generally related to the size and location of the defect. 1.Automatic closure of ventricular septal defect: The rate of automatic closure of ventricular septal defect is higher than atrial defect, so the proportion of ventricular septal defect is higher in adult congenital heart disease, besides ventricular defect may be easier to be detected early due to more obvious symptoms, automatic closure of a significant proportion of ventricular defects should also be one of the reasons. Judging from the size of the defect, small and medium-sized ventricular defects, especially those less than 5 mm, are more likely to close spontaneously; in terms of defect site, the myocardial ventricular defect is most likely to close spontaneously, followed by the perimembranous ventricular defect, and the more common bicuspid subvalvular ventricular defect in Orientals has almost no possibility of spontaneous closure. There is a special type of natural closure, namely, perimembranous ventricular defect combined with septal tumor formation. Septal tumors are mostly formed by tricuspid valve tissue, accessory tissue, or other fibrous tissue adhering to the edge of the ventricular defect and forming a sac-like structure convex to the right ventricle, which can reduce the shunt and even close the ventricular defect completely. Automatic closure of the ventricular defect is generally more common within 1 year of age and decreases with age, and the chance of natural closure after 5 years of age is already small, but not absolutely impossible. Ventricular defects with a defect size of 3 mm or less generally do not have a significant impact on the growth and development of the child, nor do they aggravate or induce respiratory infections, so they can be treated without active treatment. There are clinical concerns about whether such patients are at risk for infective endocarditis. In fact, with such widespread use of antibiotics today, the chances of infective endocarditis are already very small and minimal, and it is generally not so great as to be drug-free. There are some patients who are adamant about treatment because of their own or their family’s psychological burden. 2.Interventional surgery: Generally speaking, perimembranous (or with septal tumor formation) and muscular ventricular defects over 3 years old and with defect size of 3-14 mm can be treated by non-open-heart intervention. There have been some debates in China and abroad about whether ventricular septal defect can be treated by interventional therapy, mainly because the application of imported Amplatzer ventricular defect blocker leads to about 4% of patients with AV block, while the occurrence of domestic blocker is rare (less than 1%, lower than surgical procedure). It is now believed to be a defect in the structural design of the blocker. Imported blockers only have eccentric umbrella, while domestic blockers have eccentric, symmetrical, thin waist and other types, so different blockers can be selected according to different situations. 3.Surgery: Applicable to all types of ventricular septal defect, the disadvantages are still the surgical scars and extracorporeal circulation problems. Most of the ventricular septal defects need early surgery because they cannot heal by themselves and are prone to early pulmonary hypertension, which affects the growth and development of the child. 4.Mosaic treatment: For myocardial ventricular defect, due to its special location and more muscle bundles around the defect, it is not easy to patch repair, and conventional interventions are not easy to establish the track, and easy to cause tissue damage. In recent years, some units have developed medical-surgical mosaic treatment such as open-chest direct view interventional blocking of myocardial ventricular defects via right ventricular free wall puncture, or extracorporeal circulation interventional blocking of myocardial ventricular defects via the right atrium to treat infants with non-restrictive myocardial ventricular defects, or blocking myocardial ventricular defects while completing surgery for complex cardiac malformations, which has further improved the safety and effectiveness of the treatment of these ventricular defects. In addition, in recent years, some doctors in China have used direct cardiac vision to place Amplatzer blockers via right ventricular free wall puncture to seal perimembranous ventricular defects, and called it a mosaic treatment option. Although this treatment method can avoid extracorporeal circulation, it is questionable today when the technology of peripheral puncture vessels for sealing perimembranous ventricular defects is very mature.