A two-hole atrial septal defect of 7 mm is a severe atrial septal defect, which can be treated with medication first. The first step is to improve cardiac function with diuretics such as spironolactone, vasodilators such as isosorbide mononitrate tablets, and cardiotonic drugs such as digitalis. If the disease is complicated by arrhythmias, antiarrhythmic drugs should be given; if the disease is complicated by cardiogenic shock, symptomatic treatment such as rehydration, volume expansion and even blood pressure elevation should be given. Surgical treatment at the age of 3-6 years is the most critical treatment for severe atrial septal defect, and interventional closure of atrial defect can be considered first.