Congenital heart disease

The era of surgical correction of congenital heart defects began in 1938 when Robert E. Gross successfully ligated a patent ductus arteriosus (PDA) in a 7-year-old child at Boston Children's Hospital.1 This historical milestone was followed by several different closed-heart operations for children with congenital heart defects, including the Blalock-Taussig shunt, 2 coarctation repair, 3 and pulmonary artery banding.4 In 1952, the first open-heart operation, closure of an atrial septal defect (ASD), was performed by F. John Lewis at the University of Minnesota using hypothermia and inflow occlusion.5 One year later, John Gibbon performed the first open-heart surgery using cardiopulmonary bypass, also closing an ASD.6 At the University of Minnesota, C. Walton Lillehei performed the first repair of ventricular septal defect (VSD), tetralogy of Fallot, and atrioventricular canal (AVC) using cross circulation: the parent was the heart-lung machine.7 At the same time, at the Mayo Clinic, Dr. John Kirklin was also pioneering open-heart surgery using a heart-lung machine.8 The significant historical milestones in congenital heart surgery are summarized in Table 76.1.