What is my brother's current heart condition and does he need surgery for his ASD and mitral regurgitation? - #29618

Birth report (new born time) Situs solitus → heart normal position la iruku AV discordance → atrium–ventricle connection normal illa VA discordance → ventricle–artery connection maari iruku Aorta from RV → aorta right ventricle la irundhu poguthu Pulmonary artery from LV → pulmonary artery left ventricle la irundhu poguthu Large non-restrictive VSD → periya hole (ventricles kulla) iruku Bidirectional shunt → blood rendu direction la mix aaguthu No pulmonary hypertension → lungs pressure illa (good) No vegetation/thrombus → clot illa Valves intact → valves ok 👉 Impression: Congenital heart disease Corrected transposition of great arteries (TGA) Large VSD 👶 Age 5 report Situs solitus, Levocardia (SLL) → heart normal side la iruku Atrioventricular discordance → atrium–ventricle mismatch Ventriculoarterial discordance → artery connection mismatch Subpulmonic VSD → hole pulmonary side pakkam iruku Secundum ASD → atrium laum oru hole iruku Pulmonary hypertension (HT) → konjam lung pressure increase No CHF → heart failure illa No PS → pulmonary stenosis illa SR → sinus rhythm (normal heartbeat) 👉 Extra notes: Left coronary artery from right sinus Right coronary artery from left sinus Age 23 – Echo Report (KG Hospital) Corrected TGA → Aorta & pulmonary artery connection maari iruku (birth condition continue) Situs solitus, Levocardia → Heart normal position la iruku (good 👍) AV, VA disconcordant → Heart connections normal illa (expected in TGA) IVC draining into RA → Body la irundhu blood right atrium ku varudhu (normal) 3 Pulmonary veins draining into LA → Lungs la irundhu blood left atrium ku varudhu Aorta draining into RV & PA draining into LV → Artery connections reverse ah iruku Trabeculation seen in RV → Right ventricle muscle structure visible (usually ok) AML small, PML prolapse + moderate mitral regurgitation → Mitral valve la problem → moderate leak iruku 1.3 cm Ostium Secundum ASD → Upper chambers kulla hole iruku (size important ⚠️)but doctor tell printing mistake 1.3mm IVS intact → Ventricles middle wall correct ah iruku (no VSD now) No PDA / PS → Extra defects illa (good 👍) Left arch, No CoA → Aorta structure normal (no narrowing) Normal biventricular function → Heart pumping nalla iruku (very good 👍) No regional wall motion abnormality → Heart muscle movement normal Normal pericardium → Heart outer layer normal Hello Doctor, I’m feeling confused about my brother’s heart condition and would like your guidance. He was diagnosed at birth with congenital heart disease (Corrected TGA with large VSD). At that time and again at age 5, doctors said surgery would be very risky, so it was not done. Now he is 23 years old. His recent echo report shows: - Corrected TGA - 1.3 cm Ostium Secundum ASD (but we were told it might be 1.3 mm – need clarification) - Moderate mitral regurgitation - Normal biventricular function Currently, he does not have major symptoms. I have a few doubts: 1. What exactly is his current condition – is it serious or stable? 2. Is surgery needed now or can it be managed with monitoring? 3. What is his expected long-term outlook (life expectancy)? 4. Should we repeat the echo to confirm the ASD size? Please guide us on what to do next and how to manage his condition properly. Thank you.