Abstract
Background and Aim of the Study: Congenital heart disease is
the most common congenital defect among infants born in the United
States. Within the first year of life, 1 in 4 of these infants will need
surgery. Only one generation removed from an overall mortality of 14%,
many changes have been introduced into the field. Have these changes
measurably improved outcomes? Methods: The literature search
was conducted through PubMed MEDLINE and Google Scholar from inception
to October 31, 2021. Ultimately, 78 publications were chosen for
inclusion. Results: The outcome of overall mortality has
experienced continuous improvements in the modern era of the specialty
despite the performance of more technically demanding surgeries on
patients with complex comorbidities. This modality does not account for
case-mix, however. In turn, clinical outcomes have not been consistent
from center to center. Furthermore, variation in practice between
institutions has also been documented. A recurring theme in the
literature is a movement towards standardization and universalization.
Examples include mortality risk-stratification that has allowed direct
comparison of outcomes between programs and improved definitions of
morbidities which provide an enhanced framework for diagnosis and
management. Conclusions: Overall mortality is now below 3%,
which suggests that more patients are surviving their interventions than
in any previous era in congenital cardiac surgery. Focus has
transitioned from survival to improving the quality of life in the
survivors by decreasing the incidence of morbidity and associated
long-term effects. With the transformation towards standardization and
interinstitutional collaboration, future advancements are expected.