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The atrial septal defect, the size of the hole is very important. Studies show that a hole of 8 mm over a period of 15 days, 50% will close. Others we will have to wait and watch. Atrial septal defect is not a killer as such. You can wait upto 3rd decade, that is 30 years of age. Until then keep on monitoring and watch .If the atrial septal defect is not closing at the age or 5 or 6, if the shunt is more, we have to close it surgically. If the shunt is 1.5 :1, we have to close it surgically. If the size is small, it is expected to close by itself, its not sure that it will close, but if doesn’t close, we have to go for surgery. We have to calculate if the shunt is more, the child will have to undergo a surgery or through a device closure.