The hole in her heart may be due to atrial septal defect (ASD) or ventricular septal defect (VSD) Atrial septal defect (ASD) repair * The atrial septum is the wall between the left and right atria (upper chambers) of the heart. There is a natural opening before birth that usually closes on its own when a baby is born. When the flap does not close, the child has an ASD. * Sometimes ASDs can be closed without open-heart surgery. First, the surgeon makes a tiny cut in the groin. Then the surgeon inserts tubes into a blood vessel that go into the heart. Next, 2 small umbrella-shaped clamshell devices are placed on the right and left sides of the septum. These 2 devices are attached to each other. This closes the hole in the heart. Not all medical centers do this procedure. * Open-heart surgery may also be done to repair ASD. Using open-heart surgery, the septum can be closed using stitches, or sutures. Another way is to cover the septum with a patch made of membrane or a man-made material. Ventricular septal defect (VSD) repair * The ventricular septum is the wall between the left and right ventricles (lower chambers) of the heart. A hole in the ventricular septum is called a VSD. * By age 8 for most children with this problem, small VSDs often close on their own and do not need surgery. This depends on where the hole is. * Larger VSDs, small ones in certain parts of the ventricular septum, or ones that cause heart failure or endocarditis (inflammation) need open-heart surgery. They also require placing a man-made patch over the hole to cover it. * Some septal defects can be closed using heart catheterization (passing a thin tube into the heart).