Paediatric cardiology: The last 50 years

Abstract

In the last half-century, the outlook for children with heart disease has changed dramatically. Morphologists have transformed our understanding of heart defects. Improved imaging methods, such as echocardiography, computed tomography and magnetic resonance imaging, have made diagnostic cardiac catheterisation almost redundant. However, interventional catheterisation has flourished as transcatheter procedures have replaced surgery for many lesions. The ability to pharmacologically manipulate the duct has revolutionised the management of the sick neonate with major heart disease. Better surgical techniques, such as deep hypothermia and circulatory arrest, allow repair of lesions in early infancy before irreversible complications develop. Advances in anaesthesia and intensive care have been integral. New sub-disciplines, such as fetal cardiology and electrophysiology, have emerged. The sum of these numerous developments is enormous. Lesions that were previously considered lethal are now routinely treated. Consequently, the great majority of children with major heart disease now reach adulthood in good health.

Clinical feasibility of pre‐operative neurodevelopmental assessment of infants undergoing open heart surgery

“…Refinements in surgical procedures and medical management in the past 50 years have resulted in dramatic improvements in the survival of children born with congenital heart disease (CHD) . Survival of infants who have undergone open heart surgery within the first year of life, however, can be accompanied by significant risk of neurodevelopmental delay .…”

Computed tomography-based survey of the vascular anatomy of the juvenile Göttingen minipig

“…3 For example, image-guided transcatheter interventions, such as balloon atrial septostomy, have evolved to become suitable alternatives to surgery in the field of paediatric cardiology. [4][5][6][7][8][9][10] Applications are transposition of the great vessels, 9 mitral valve stenosis, 8 haemodynamical significant atrial septum defects 9 and critical pulmonary valvar stenosis. 9 Apart from paediatric cardiology, there are other applications including congenital and infantile vascular malformations, 11,12 embolization of tumours, and bleeding.…”