Curative Repair in Pediatric Cardiac Surgery is Increasingly Feasible

Abstract

As demonstrated almost every month in the relevant journals, curative surgical repair for congenital anomalies of the heart and the thoracic vessels is increasingly feasible and can be accomplished at a very young age as well. Most likely the trend towards repair of these anomalies very early in life will continue. In this regard, even fetal surgery may sometime in the future become part of the cardiac surgical practice [1, 2]. However, to put the concept of “curative surgery” into the right perspective, it should be realized that there is also an increase in the number of adolescents and adults coming for surgical repair of congenital anomalies of the heart and thoracic vessels [3, 4, 5]. For some of these older patients this is the first operation, because they have been asymptomatic or because the risk of surgery decreased below the gradually increasing risk of ongoing conservative treatment. For an increasing number of these older patients, however, this means a reoperation, the patient being a survivor of surgical therapy performed in infancy and childhood [3, 4, 5]. The specific problems of this older patient group will not further be addressed to in this chapter. Also issues concerning cardiac and cardiopulmonary transplantation will not be discussed.