Historical Considerations Ingenious and risky surgical corrections of atrial septal defect (ASD) predated cardiopulmonary bypass. The earliest closed approaches included a technique in which a straight needle with suture, guided by palpation, was passed blindly through the defect and both…
Included under the rubric of congenital heart defects are abnormalities involving the distal transverse arch and proximal descending aorta. Clinical manifestations range widely, from severe congestive heart failure or debilitating stridor to mere incidental finding on routine evaluation. The treatment…
History of Pediatric Tracheal Surgery In 2000, the Congenital Heart Surgery Nomenclature and Database Project classified congenital tracheal stenosis as congenital–complete tracheal rings, postintubation, traumatic, or congenital web. Localized stenosis was defined as less than 50% of the tracheal length,…
History of Intraoperative Neuromonitoring Brain injury is the most common and potentially disabling complication following congenital heart surgery. With improved survival, the focus has shifted to optimizing functional outcomes. An important goal of therapy for every congenital heart surgical patient…
The management of congenital heart disease (CHD) has progressed significantly over the past three decades. Most congenital heart lesions are now amenable to anatomic or physiologic repair early in infancy. Advances in diagnostic and interventional cardiology, the evolution of surgical…
For infants and children, mechanical support of the circulation has important roles in providing short-term circulatory support for reversible myocardial failure, in providing cardiopulmonary support before and after cardiac surgery, and in providing longer-term support as a potential bridge to…
Thoracic incisions traditionally used in adult cardiac and thoracic surgery have been used in children with varying success with respect to exposure, pain, and cosmetic result. Special considerations relevant to pediatric surgery are related to the lack of development and…
Introduction and Overview Catheterization in the field of congenital cardiology continues to improve understanding of disease and expand options for therapy. Diagnostic information previously obtained exclusively through catheterization is now routinely acquired through use of a host of diverse and…
Before the advent of cardiopulmonary bypass in the mid-1950s, little attention was given to the diagnosis of congenital heart disease (CHD) because no effective treatment was available. Physical examination, auscultation, electrocardiography, and radiography were the main diagnostic tools. Progress in…
Development of the functioning heart is a complex process that is essential for survival of the embryo. The mechanisms responsible for cardiovascular morphogenesis have been studied for centuries by classical embryologists and more recently by molecular developmental biologists. Major progress…