New surgery for better outcomes: shaping the field of congenital heart disease.

BACKGROUND: The field of congenital heart disease is constantly evolving through better understanding of the disease itself, albeit its history, prevalence, genetics, and follow-up. Concurrently surgical techniques and approaches have been developed, modified, and refined. DATA SOURCES: The impact of interventional pediatric cardiology has been dramatic. The field of catheter-based therapies has exploded with the first pulmonary valve balloon angioplasty in 1982. With evolving stent technology, they are now used in multiple areas, including pulmonary arteries, vena cavae, aortic and arch and descending aorta for coarctation. The hybrid surgery concept involves a multidisciplinary team of interventional cardiologist and surgeon combining catheter-intervention and surgery in the surgical theater such as pulmonary artery stent implantation associated with pulmonary valve replacement. Furthermore, in selected cases, pulmonary valve device implantation is becoming an accepted approach to a surgical problem.
RESULTS: Balloon angioplasties, stent implantations, hybrid surgeries and pulmonary valve device implantation are performed with a very low mortality and morbidity. The risks and benefits outweigh the ones associated to surgical procedures.
CONCLUSION: With fast developing interventional therapies, the work of pediatric cardiologists and cardiac surgeons is more intertwined than ever in search of better outcomes for the children with congenital heart disease.