Recent advances in neonatal cardiac surgery.

Several major advances in the field of neonatal cardiac surgery have improved the outcome of these severely ill patients. Among the preoperative advances are improvement in the management of patients with single ventricle equivalents, prenatal diagnosis, and interventional procedures. Intraoperative advances include better understanding of the inflammatory process caused by cardiopulmonary bypass and ways to manage it, newer techniques for treating hypoplastic left heart syndrome and aortic valve disease, and primary repair of complex lesions. Postoperative refinements in managing pulmonary hypertension, low cardiac output state, and ventricular assist devices have decreased surgical mortality and morbidity. Although his primary interest has been adult cardiac surgery, Dr. Geha has contributed directly and indirectly to these advances.