Ventricular function in surgery for congenital heart disease

BACKGROUND The history of measuring myocardial edema by two-dimensional echocardiography and the pathophysiology of myocardial edema are reviewed. METHODS The relevance of this subject to management of children undergoing corrective surgery for single ventricle physiology and tetralogy of Fallot is reviewed. RESULTS Evidence is presented that myocardial edema is an ongoing clinical problem with relevance to management and outcomes. Methods for measuring mass increases noninvasively in the range of 10-25% with increases in myocardial water content on the order of 2-4% are now well established. CONCLUSIONS These methods and advanced animal models replicating conditions of surgery for cyanotic congenital heart disease set the stage for clinical advances in this important area.