Recent development of congenital heart surgery in neonates and small infants

Cardiac surgery has been developed dramatically during these 50 years since Gross and Lellihei pioneered repair of intracardiac anomalies using cardiopulmonary bypass in mid 1950's. In late 1960's and early 1970's, the technique of deep hypothermia and circulatory arrest (DHCA) has been developed in Japan and Sir Brian Barratt-Boyes in New Zealand used Kyoto technique (DHCA) to repair many infants and small children with complex congenital heart diseases (CHD). The introduction of DHCA was an important development in the history of the treatment of CHD, allowing the approach of previously unrepairable lesions. Open heart surgery in neonates has been adopted worldwide since Castaneda in Boston performed neonatal arterial switch in mid 1980's. Since then, most of our efforts have been led to repair most of the CHD primarily in neonate and small infants. Mortality of open heart surgery in neonates has dropped significantly during recent 10 years and now, more than 95% of the children with CHD survive in Japan. Surgical strategies and results in each CHD were summarized.