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[Recent development of congenital heart surgery in neonates and small infants]
1Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan.
Insights
Cardiac surgery has advanced significantly, improving outcomes for congenital heart disease (CHD). Modern techniques now allow over 95% survival for children with CHD in Japan.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
Context:
- The evolution of cardiac surgery over 50 years has dramatically improved treatment for congenital heart diseases (CHD).
- Pioneering work in the mid-1950s introduced cardiopulmonary bypass for intracardiac anomaly repair.
- The development of deep hypothermia and circulatory arrest (DHCA) in the 1970s enabled complex CHD repairs in infants.
Purpose:
- To summarize surgical strategies and outcomes for various congenital heart diseases.
- To highlight key advancements in pediatric cardiac surgery.
- To review the historical development and current state of CHD treatment.
Summary:
- Cardiac surgery has seen dramatic advancements since the 1950s, including cardiopulmonary bypass and deep hypothermia and circulatory arrest (DHCA).
- Open heart surgery in neonates became widespread in the 1980s, focusing on primary repair of CHD in infants.
- Surgical outcomes have improved, with over 95% survival for children with CHD in Japan in the last decade.
Impact:
- DHCA allowed surgical repair of previously inoperable congenital heart lesions.
- Neonatal open heart surgery has significantly reduced mortality rates.
- Current surgical strategies focus on primary repair, leading to high survival rates for pediatric CHD patients.
Abstract:
Cardiac surgery has been developed dramatically during these 50 years since Gross and Lellihei pioneered repair of intracardiac anomalies using cardiopulmonary bypass in mid 1950's. In late 1960's and early 1970's, the technique of deep hypothermia and circulatory arrest (DHCA) has been developed in Japan and Sir Brian Barratt-Boyes in New Zealand used Kyoto technique (DHCA) to repair many infants and small children with complex congenital heart diseases (CHD). The introduction of DHCA was an important development in the history of the treatment of CHD, allowing the approach of previously unrepairable lesions. Open heart surgery in neonates has been adopted worldwide since Castaneda in Boston performed neonatal arterial switch in mid 1980's. Since then, most of our efforts have been led to repair most of the CHD primarily in neonate and small infants. Mortality of open heart surgery in neonates has dropped significantly during recent 10 years and now, more than 95% of the children with CHD survive in Japan. Surgical strategies and results in each CHD were summarized.
