SURGICAL-MANAGEMENT OF CONGENITAL HEART-DISEASE IN THE 1990S

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.