Limiting the Lifetime Surgical Impact of Congenital Heart Disease and Guiding Care for the Congenital Heart Patient

Morbidity from congenital heart disease interventions has become important as mortality decreases. Avoiding cumulative physiologic and psychological trauma over a lifetime is now an important goal. Strategies to minimize surgical impact include transcatheter palliation, transcatheter occlusion of patent ductus arteriosus in very premature babies, and transcatheter valve replacement. Other strategies to minimize cumulative trauma are reviewed including subcutaneous defibrillators, leadless and MRI-conditional pacemakers, blood conservation/bloodless cardiac surgery, effective pain management, reduction of radiation exposure, optimizing neurodevelopment, and reducing psychological stressors.