It is my pleasure to introduce the 2013 edition of the Pediatric Cardiac Surgery Annual. The overarching theme is “neonatal cardiac surgery.” While many pediatric cardiac
surgical procedures have been well worked out and our overall outcomes have improved
to the point that “mortality” is no longer useful as a statistical variable (because
it occurs so rarely), neonatal cardiac repairs remain the last bastion of true surgical
prowess. Nowhere is it truer that the technical outcome achieved by the surgeon at
the time of exit from the operating room will determine the clinical outcome to an
enormous degree. Perfection has to be the goal every time, and experienced intensivists
will agree that a perfect repair will often guarantee a smooth and uneventful postoperative
course. Even modest and temporary intraoperative mishaps, such as phrenic nerve, recurrent
laryngeal nerve palsy, extended time of cardiopulmonary bypass, or imperfect myocardial
protection, will affect neonates to a disproportionate amount, prevent timely extubation,
result in the inability to close the chest, etc. Thus, neonatal cardiac repairs are
the last frontier, and I wanted to focus on this group and provide experts the opportunity
to weigh in on some controversial areas.
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© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
