[Congenital heart diseases surgically treated in childhood. Long-term results]

Surgery for hereditary cardiopathies has made much progress over the last 25 years. For left/right ventricular shunts, mortality is 5% and quality of life is satisfactory in 85% at five years. All interventricular communications with major pulmonary hypertension should be operated during the first year of life. When surgery is indicated for atrial left/right shunt the operation should be done before the age of 4 or 5 years. Results for Fallot's tetralogy are now excellent with an actuarial survival of more than 30 years in 86% of simple forms after curative surgery. Complete repair should be done early (12 to 18 months) to reduce dysrhythmia and right ventricular hypertrophy. Corrective atrial surgery for transposition of the great vessels, a totally physiological operation, has been replaced by anatomic correction, improving prognosis to more than 90% survival and only 10% reoperation rate. Surgery for coarctation of the aorta gives very good results modulated by the risk of recurrence, especially when performed early (before 6 months). Medical-surgical management of hereditary cardiopathies begins at birth. Surgery for all operable malformations should be performed before the end of the second year of life, allowing for nearly normal life, both at home and at school.