Innovations in congenital heart surgery

Pediatric heart surgery is still a young discipline. The first operations to treat congenital heart diseases were done in the early 1940s and its real expansion ensued after intra-cardiac procedures were feasible with acceptable risk following wider access to the use of cardio-pulmonary bypass machine. The first two decades of existence of this specialty saw a whirlwind of new procedures making it one of the most quickly evolving specialty. Pioneers tested and abandoned operations by rapid trials and errors, shaping our specialty at an unbelievable speed [1,2]. The latest big landmark procedure of our specialty was the Norwood procedure that was introduced in 1980 [3]. The results of this extremely complex procedure kept improving until after the turn of the century. But since around 2005, our results for the Norwood procedure seem to have stagnated [4]. A similar trend has been observed across several conditions treated in our specialty [5]. So, we have seen a slowing down of new procedures offered to our patients. Have we gone cold on innovations? Let us see the changes seen in the last 15 years.