Surgical management of congenital heart disease in the 1990s
D. M. Cohen
School of Medicine, Division of Cardiothoracic Surgery, East Carolina University, Greenville, NC.
OBJECTIVE--To provide a broad overview of recent trends in surgical
management of congenital heart disease. DESIGN--Review of recent
literature. SETTING--Major centers for surgical management of congenital
heart disease. SELECTION PROCEDURES--Analysis of important recent clinical
publications. INTERVENTIONS--None. RESULTS AND CONCLUSIONS--Definitive,
corrective surgery was previously reserved for children beyond infancy.
Recognition of the complications associated with palliative operations as
well as the realization that neonates and infants did not fare worse than
older children during open heart surgery provided the impetus for primary
corrective surgery at an earlier age. Advances in our understanding of
perioperative care, improved diagnostic capability, and increasing
experience with corrective surgery in association with several different
congenital heart lesions has resulted in an established therapeutic
approach to surgical management of congenital heart disease in neonates and
infants.
