Perspective on Congenital Heart Disease Research
- cardiopulmonary bypass
- congenital heart disease
- congenital heart surgery
- heart failure
- pulmonary artery
Congenital heart disease (CHD) is the most common birth defect and a leading cause of morbidity and mortality in patients with congenital malformations. The past 7 decades have witnessed dramatic advances in the medical, catheter, and surgical management of these patients. Clinical research has been a driving force to improve our understanding of the pathophysiology of disease and to refine therapy. Here, we identify some of the themes that have characterized the research process in the past and that have propelled the field to its present state. We discuss current research-related challenges and speculate about what trends may define the future of CHD research.
The historical canon of congenital heart disease (CHD) is replete with dramatic triumphs: the first open heart surgery, the first use of cardiopulmonary bypass, the first transcatheter interventional cardiac procedure, and many others. In the years since these seminal events, progress has been made in all aspects of the care for patients with CHD. Prompt diagnosis is routine, surgical management of the most complex lesions is achievable, and acute and chronic care of patients has been refined. Important challenges remain, including persistent mortality for particular complex defects and long-term problems such as neurodevelopmental abnormalities, arrhythmias, and heart failure. Nevertheless, there are many reasons to be proud, and clinical research has been a foundational feature that has helped drive much of this progress. We describe some trends in research that have propelled the field to its current state and speculate about what trends may define the future of CHD research.
Past and Present CHD Research
Individual to Group Science
A defining trend of the past 75 years of CHD research has been the change in focus from the individual to the group. Early CHD research was performed by individuals trying to solve problems, 1 child at a time. Innovative thinkers and doers—Gross, Lillehei, Rashkind, and Norwood—pushed …