Core Viewpoint - The article discusses the medical controversy surrounding a child's heart surgery at Ningbo Women's and Children's Hospital, focusing on the size of the atrial septal defect (ASD) and the implications for surgical intervention [1][2]. Group 1: Medical Context - The child, a premature infant, was diagnosed with two atrial septal defects, which are common in premature infants and may self-resolve; however, larger defects typically require intervention [2]. - Surgical indications for ASD in children are flexible, with larger defects (diameter >8mm) generally requiring intervention due to low chances of self-resolution [2]. - Clinical assessment for surgery considers hemodynamic changes and the presence of symptoms, with early-stage defects often asymptomatic, leading to potential delays in treatment [2][3]. Group 2: Surgical Techniques and Equipment - Treatment for ASD can be performed via minimally invasive techniques or open-heart surgery, with specific indications for each based on the defect's characteristics [3]. - The choice of surgical method and equipment depends on the type, size, and location of the defect, as well as the individual patient's condition [3]. - Surgical materials include autologous pericardium or processed bovine pericardium for repairs, while interventional procedures utilize occluders made from nickel-titanium alloy [3]. Group 3: Epidemiological Data - Recent epidemiological studies indicate that the incidence of congenital heart disease in China ranges from 8‰ to 10‰, with ASD accounting for approximately 10%-15% of all congenital heart defects [4]. - Based on these statistics, the birth prevalence of ASD is estimated to be between 0.8‰ and 1.5‰, translating to about 0.8 to 1.5 cases per 1,000 live births [4].