The Evolution of Surgical Treatment for Congenital Cardiac Disease

The goals of reparative surgical therapy for any disease are to restore function and life expectancy to normal. The development of cardiopulmonary bypass and the implementation of techniques of reparative surgery for patients with congenital cardiovascular malformations in the 1950s and 1960s introduced the reality of reparative surgery in patients with otherwise fatal cardiovascular disease. Attention was initially focused on ensuring survival through the surgical procedure and in the early postoperative period. As the number of patients with "repaired" congenital cardiovascular disease increased, long-term follow-up of these patients became possible. The report by Morris and Menashe¹ in the Journal of theAmerican Medical Association analyzes long-term survival and the cause of late death after repair of eight common congenital cardiovascular malformations. This cohort of patients included all children from the state of Oregon who underwent reparative surgery for one of these congenital cardiac defects before age 18 years. The