According to the echo it appears that the ASD is stable, and not getting much bigger. The left side of her heart is enlarged from the excess flow. However, Dr. Allen is concerned that she isn’t growing according to the normal growth curve. Since her last appointment with him she has gone from the 40th percentile to the 3rd percentile. He believes that the ASD is to blame since she is healthy otherwise and eats like crazy! It concerns him that the ASD appears to be stunting her growth. He wants us to come back in 6 months and track her weight between now and then. At that appointment if she has not improved he said that we will probably have to discuss open heart surgery to fix the ASD. Thankfully he is willing to wait 6 months to see if there is an improvement; although he seemed worried about her current growth trend.