I am really confused about ASD ....... is it spontaneously close or rarely do such...?
--Kaplan book says --> usually close spontaneously in term infants
--UW says--> rarely close spontaneously and requires surgery
The majority of isolated secundum ASDs <6 mm diameter in infants close spontaneously by two years, and some as late as 5 years of age. Thus, in the absence of associated symptoms, early closure is not indicated for these defects. Defects of moderate size (at least 6 to 8 mm in diameter) and larger are relatively unlikely to close spontaneously. However, closure of even moderate and large isolated secundum ASDs is not recommended in asymptomatic patients before 2 years of age due to the possibility, however small, of spontaneous closure.
Basically, ASD's in infants (<2 years) have a chance to close spontaneously if they are small but if they are large and detected after 2 years of age, they are less likely to close and would require surgery.
I know that's not really a definitive answer but I hope that helps