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J Thorac Cardiovasc Surg 2009;138:5-7
© 2009 The American Association for Thoracic Surgery

Editorial

Surgery for adults with congenital heart disease should be performed by congenital heart surgeons

Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn

Received for publication June 20, 2008; accepted for publication August 5, 2008.

^_* Address for reprints: Joseph A. Dearani, MD, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905. (Email: dearani.joseph@mayo.edu).

The first 300 words of the full text of this article appear below.

Patients with congenital heart disease require lifelong medical care. The frequency of congenital heart disease in the population is approximately 1%. The population of the United States is approximately 295 million. Consequently, the number of citizens in the United States with congenital heart disease is estimated to be 3 million.

The introduction of cardiopulmonary bypass in the 1950s revolutionized the surgical treatment of intracardiac congenital heart malformations such as ventricular septal defect, tetralogy of Fallot, and atrioventricular septal defect. Treatment of univentricular circulations with the Fontan procedure and its modifications was introduced in the 1970s, and by the 1980s, success was achieved in complex operations performed in the neonatal period—the arterial switch procedure and the first-stage Norwood palliation for hypoplastic left heart syndrome complexes. Because 85% to 90% of infants with congenital heart disease survive now into the adult years, there is a new specialty in the care of adults with congenital heart disease. Interestingly, at the present time in North America, there are more adults than children with congenital heart disease.

The increasing population of adults with congenital heart disease is occurring with limited medical and surgical expertise to care for this unique patient population. The adult with congenital heart disease can be a patient previously operated on during infancy or childhood or a patient with congenital heart disease that has gone unrecognized until later in life.

Although many controversies and unsolved issues surround the care of adults with congenital heart disease (eg, location of care in a children's hospital vs an adult hospital), the focus of this article will be on the issue of which cardiac surgeon, adult or congenital, is best suited to deal with these operations.

What is a Congenital Cardiac Surgeon?

The congenital heart surgeon is defined as one who has completed a congenital cardiac surgery fellowship. Most practicing congenital surgeons . . . [Full Text of this Article]