Pediatric cardiac surgery

The treatment of many forms of congenital heart disease has continued to advance, and numerous reports have appeared in the last year to document these improvements. Increased information regarding the "natural history" of repaired congenital heart disease has also been reported. Based both on improving results of surgical treatment and on the problems with delayed reparative operations, there has been continued interest in primary early repair of an increasing number of defects, including atrioventricular canal, tetralogy of Fallot, pulmonary atresia with intact ventricular septum, transposition of the great arteries, and truncus arteriosus. Advances have also been reported in transplantation for complex congenital heart disease and in the "physiologic correction" of various forms of single ventricle by the Fontan approach. A number of experimental reports on the protection of both the heart and the brain during ischemia point out areas where knowledge is incomplete and where further research is needed. These developments suggest that the overall outlook for the patient with congenital heart disease has continued to improve.