1, automatic closure of atrial septal defect: The so-called automatic closure means that the atrial defect continues to develop and grow after birth until the defect closes automatically (another concept, the atrial defect does not grow with age). In general, the possibility of automatic closure of the atrial defect in the primary foramen is very small, while the possibility of automatic closure of the atrial defect in the secondary foramen is very high. The age of atrial defect autoclosure is usually within 6 years. Atrial defects (or foramen ovale) up to 3 mm in diameter have almost 100% auto-closing rate before 1.5 years of age; atrial defects between 3 and 8 mm have almost 80% chance of auto-closing within 1.5 years of age; atrial defects larger than 8 mm have very little chance of auto-closing. Another indicator can help the doctor to determine that atrial defects with significantly enlarged right ventricle have a relatively small chance of closing automatically, and those with normal right ventricle size have a high rate of self-closing. Therefore, patients with atrial septal defects generally do not need to be operated urgently. Since atrial defects below 8mm usually do not significantly affect the growth and development of children, and do not easily aggravate respiratory infections, it is perfectly possible to follow up with cardiac ultrasound at regular intervals (every 3-6 months, or even once a year) in cardiology specialists to observe whether there is a possibility of self-healing. Combined with the psychological factors of patients and families, it is believed that the lowest starting point of treatment for atrial defect is generally 5mm or more in diameter, or age 1 year or more. Interventional treatment: Interventional treatment can be applied to any type of atrial defect other than primary orifice and venous sinus type atrial defect above 3 years old and between 5mm and 36mm in diameter (generally not larger than 30mm in children). Currently, the Amplatzer atrial defect blocker is generally used, and the total cost is similar to or even lower than surgical procedures. It is minimally invasive because only 1 femoral vein is punctured. The disadvantage is that it is radioactive (equivalent to a CT scan) and requires a small dose of aspirin for anticoagulation for six months. 3.Surgical open-heart surgery: can be applied to any type and size of atrial septal defect, the disadvantage is extracorporeal circulation, surgical scar problem. 4.So-called inlay treatment: In recent years, a few units have adopted the ultrasound-guided placement of atrial septal defect blocker via right atrial wall puncture after open-heart surgery, which is called “inlay treatment”. Strictly speaking, this method is only to avoid radiation and extracorporeal circulation, but it still requires open-chest surgery. In today’s world where peripheral vascular interventions for atrial septal defects are very well established, it seems that this method is not worth the cost.