Hi, 10mm ASD at 4 yrs needs a closure
Device closure needs good margin all around. What I see is there is a deficiency in aortic margin. Therefore there will be a possibility of dislodging of device.
A pre school age is the best time to get a surgical closure.
It is hardly a 2-3 hr surgery and very safe in safe hands. Followed by 3-4 days of hospital stay.
After 1 month baby is absolutely fine.
Next Steps
A good echo ( Transthoracic/ Transesophageal) to find all the margins intact.
Good margin - Device closure or else if any doubt go for Surgical