Atrial Septal Defect in Preterm Infants: Can It Heal Naturally?

Whether an atrial septal defect (ASD) in a preterm infant can heal naturally largely depends on the size and severity of the defect. Small ASDs, typically around 6-7mm in diameter, may close on their own as the child grows. This natural closure often occurs within the first 1 to 2 years of life, especially if no other structural or functional heart abnormalities are present.

Factors Influencing Natural Closure

For natural healing to occur, doctors must evaluate the overall heart structure and function. If the ASD is isolated and relatively small, regular monitoring through echocardiograms may be sufficient. However, if the defect is large or associated with other congenital heart issues such as valve disorders or pulmonary stenosis, spontaneous closure becomes less likely.

When Intervention is Necessary

If the ASD remains larger than 5mm by the age of 2 years, or if it is accompanied by other structural or functional complications, medical intervention may be required. In such cases, catheter-based closure procedures can be considered around 2.5 years of age. These minimally invasive techniques offer a safer and more effective solution for closing larger defects and preventing long-term complications.

Early Surgical Options

In more severe cases—such as when the ASD is over 10mm and associated with pulmonary or valve abnormalities—early surgical intervention may be necessary. Surgery can not only close the defect but also repair underdeveloped valves such as the mitral or tricuspid valve, improving long-term cardiac function and quality of life.