My daughter, who is 18 years old, was found to have congenital heart disease during her medical examination this year. The echocardiogram showed “atrial septal defect, central type, 20mm, left to right shunt”. However, she has no discomfort, and when I asked different doctors, they all said different things, do I need to treat my daughter’s disease? Which is better: medical interventional occlusion or surgical open heart surgery? A: Precardiac disease is a time-limited disease, with the increase of age, the pulmonary artery pressure is getting higher and higher, to a certain extent, the best time to treat may be missed, or even completely lost, statistics show that the long-term survival rate of those who have surgery before the age of 24 is the same as the normal control group of the same age and gender. 40 years old after the operation, the long-term survival rate is only 40% of normal people. Therefore, it is important to detect and treat precardiac disease early. Your child is 18 years old and has a large atrial defect, so it is recommended to treat it as soon as possible. As for whether to use open-heart surgery or medical interventional blocking, before you make a decision, you must have a basic understanding of each treatment method and clarify its advantages and limitations. 1.Surgical open-heart repair Direct open-heart, direct-view cardiac repair under extracorporeal circulation. It can be used for almost any “treatable congenital heart disease” and has a wide range of applications. However, its biggest disadvantage is that it is very traumatic, the surgical scar is obvious, and the brain damage and neuropsychiatric dysfunction that may be caused by extracorporeal circulation are also problems that cannot be ignored. In addition, permanent scars are left on the chest after the surgery, causing permanent damage to the child’s body, mind and personality, which is not conducive to the child’s overall healthy growth; 2. Internal interventional occlusion It is performed by puncturing the femoral artery or femoral vein, inserting a special catheter, sending the special occluder from the peripheral blood vessels to reach the lesion site to be treated, releasing and fixing the occluder in the lesion site to achieve the purpose of cure. The advent of interventional therapy has brought about a fundamental change in the concept of treatment for congenital heart disease and has now become the treatment of choice for most congenital heart diseases. Advantages of cardiac catheterization intervention: no need to open the chest, no scar without affecting the aesthetics; few complications and high safety; short hospitalization time, usually discharged after 4-5 days of hospitalization; good treatment results. Of course, interventional treatment for precardiac disease has its own very strict indications, and not all precardiac patients can undergo interventional treatment. Compared with surgical procedures, its scope of application is much narrower, and it is not suitable for right-to-left shunts, severe pulmonary hypertension, combined deformities requiring surgical correction, large defects with poor margins, etc. Your child has a central septal defect, 20mm, and a left-to-right shunt, which should be treated by medical interventional occlusion.