Est. 15 mm hole ASD in baby

Hi, my son has a 15 mm size hole estimated via echocardiogram and because of it, he also has secondary pulmonary hypertension. He sees a cardiologist every other month for monitoring. He coughs ever since he was a newborn and he is on the thin side (20-30 percentile for weight), but other than that, he is asymptomatic. We’re not sure if the coughing and being thin are caused by ASD, nor are we sure the pulmonary hypertension is caused by ASD, but the hope is that once the hole closes up, whether on it’s own or with surgery (targeting 3-4 years of age to do so - looking to be via OHS), all that goes away or do not limit him in living a fairly healthy, happy, and long life.

He catches common childhood illnesses and goes to daycare. Both of which worries me because of his condition. His cardiologist has told us no restrictions as of right now, but as a parent, it worries me - just that we don’t have much options. Anyone has insight, or experience on outcome with closure as a result of early detection and whether his heart can handle it for the meantime until then?

If he has already developed PH, I am unsure why they would not perform closure now? Did they give a reason. The pulmonary vasculature can scar from high pressures. The scarring is typically not reversible. What are his pressures?

Thank you for your feedback - his next visit is on 12/3 and I will ask that question - about his pulmonary vasculature. His pressure was 50-55 at 5 months old, but he was very fussy and cranky that day, the second visit, it was in the 40s, and the last visit, it was in the 30s. He also has all the other signs of PH, like shunting, enlarged lower right chamber, etc.

We were told he can wait since he is asymptomatic and seemingly growing, etc. He isn’t on any medication either although that was talked about - because of the coughing. The cardiologist wants to give him time to grow and develop - hopefully close although medically speaking unlikely given the size, severity, and shape - and see how he manages and I was told that his heart now and body now can tolerate it - give him time. I hope nothing gets compromised and permanently irreversible to a point where it changes his quality of life majorly.