Surgical treatment of congenital heart conditions: It’s now or never!

Abstract

Pediatric cardiac surgeons from the fraternity were invited to pen down their learning and insight on topics of their interest. We did not want pedagogical write-ups, but essential material of practical use. To those of us having difficulty getting off the blocks, our advice was: Just write down the essentials on the topic that you can think of, what guidelines you use in your practice, your experience with these groups of patients, and your opinion of the future of care of this condition. And then build around all these points. The contributions have been compiled in this issue, and hopefully in another to follow. Because congenital heart conditions are as myriad as the fish in the sea, and, for those dealing with them day in and day out, the collected data so invaluable and diverse, one, or even 2 issues, will not suffice. This first special issue is therefore a compilation of topical reviews, thoughts, and personal experiences of the contributors on various topics of contemporary importance. Of note, all the contributors are from India, where they attained part or all of their training in cardiac surgery, though some are currently located abroad. From the borderline left ventricle to atrioventricular canal to the anatomic repair of abnormal great arterial connections using the recent techniques of root transfers, to coronary interventions in children, the topics cover a wide range. The opening chapter tracing the beginnings of cardiac surgery in India is a landmark contribution, I feel. Because that is when the DNA of our profession, its work ethic, was laid down. To date, it serves as inspiration for us to emulate. The origins of cardiac surgery in India can be traced back to the inspiring and hard work of the pioneers in the 1960s. These times were fairly contemporary with the birth of open intracardiac repair in the world. Making the indigenous heart lung machine in those times, a feat (sadly) un-replicated ever since, and popularizing its use in many centers of the country were stellar achievements indeed, in times when communication and travel were tedious. Those times and succeeding endeavors and accomplishments are captured by Dr. Krishna Manohar in the opening pages. We are indebted to him for treating this important topic seriously enough to take the time (and pleasure) to visit many of our heroes in their homes and hometowns, individually, for a personal interview.My request that his delivery be captured verbatim, without alteration, was generously acceded to by our honorable editor, and for that I am grateful. Another dedication is about the availability and affordability of pediatric cardiac surgery all over the world—a grim reminder of the alarming state, children’s health is in, in most of the world, even in the twenty-first century. India has the dubious distinction of being among those nations where, even though high-quality cardiac care is available, its scale is limited and its affordability beyond the reach of 98% of the children requiring intervention. All in all, I hope the issue and the following one prove a precious contribution by our very own, for our very own, surgeons in different parts of the world who are in similar situations as us, and for posterity.