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Congenital Heart Surgery Nomenclature and Database Project: palliation, correction, or repair?
1Department of Surgery, Medical University of South Carolina, Charleston 29425, USA.
Insights
Cardiac surgery terminology like palliation, repair, and correction is often inconsistent. This study clarifies usage, suggesting repair and correction are interchangeable, while palliation should denote non-normalizing operations.
Area of Science:
- Cardiovascular Surgery
- Medical Terminology
- Congenital Heart Disease
Background:
- Inconsistent terminology in cardiac operations (palliation, repair, correction) leads to unclear thinking about surgical goals.
- Actual usage of these terms in scientific literature has not been previously documented.
Purpose of the Study:
- To analyze the current usage of palliation, repair, and correction in cardiac surgery literature.
- To provide recommendations for consistent and etymologically accurate terminology in congenital heart disease operations.
Main Methods:
- Systematic review of all articles concerning congenital heart disease published over two years.
- Inspection of articles from 'The Annals of Thoracic Surgery' and 'The Journal of Thoracic and Cardiovascular Surgery' for classification terms.
Main Results:
- Repair and correction were used interchangeably in 301 reviewed articles.
- Palliation was generally used distinctly but occasionally misapplied.
- Etymological analysis suggests 'correction' is more appropriate for congenital heart operations than 'repair'.
Conclusions:
- Repair and correction can be used interchangeably in cardiac surgery literature.
- Palliation should be reserved for operations not intended to achieve normal cardiac physiology.
- Consistent terminology is crucial for clear communication in cardiac surgery.
Background:
Inconsistent use of the terms palliation, repair, and correction, fosters unclear thinking about the goals of cardiac operation. Actual usage of these terms has not been previously documented.
Methods:
Every article, for two years, pertaining to congenital heart disease in The Annals of Thoracic Surgery and The Journal of Thoracic and Cardiovascular Surgery was systematically inspected for terms of classification.
Results:
In the 301 articles reviewed, repair and correction were used virtually interchangeably. Palliation was generally used distinctively, but all 3 descriptors were used for 3 operations. The etymology of each descriptive term suggests that they have distinct traditional definitions and connotations. Repair suggests returning to normal that which was once normal, while correction carries no implication of prior normalcy; thus, correction is the more etymologically correct term for congenital heart operations. In current literature, palliation is used improperly for a few operations to denote lack of anatomic correction or lack of permanence of correction.
Conclusions:
Because proper usage reflects both etymology and actual usage, we suggest that repair and correction may be used interchangeably. Palliation, however, should describe only operations that are not intended to provide normal cardiac physiology.
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