Why might surgical repair of a small VSD be deferred in a young child?

Deferring surgical repair of a small ventricular septal defect (VSD) in a young child is primarily based on the understanding that many small VSDs have a significant chance of closing spontaneously. In particular, there is a substantial likelihood that a small VSD will close by the time the child reaches age two years. Pediatric cardiologists often monitor these defects during routine follow-up visits, as children with small VSDs generally do not show significant symptoms or complications.

Because of this potential for natural closure, the medical approach favors a conservative strategy, especially if the child is otherwise healthy and not experiencing issues such as growth failure or heart failure symptoms. Surgical intervention is typically reserved for cases where the VSD is large, symptomatic, or causing hemodynamic compromise. By closely monitoring the small VSD, the healthcare team can make an informed decision about whether surgical repair is necessary based on the child's progress and overall condition.

This approach contrasts with other options that either suggest unnecessary interventions or do not align with current best practices in managing small VSDs.