CONGENITAL HEART-DISEASES OPERATED IN CHI LDHOOD - LONG-TERM RESULTS

Surgery for hereditary cardiopathies has made much progress over the l ast 25 years. For left/right ventricular shunts, mortality is 5% and q uality of life is satisfactory in 85% at five years. All interventricu lar communications with major pulmonary hypertension should be operate d during the first year of life. When surgery is indicated for atrial left/right shunt the operation should be done before the age of 4 or 5 years. Results for Fallot's tetralogy are now excellent with an actua rial survival of more than 30 years in 86% of simple forms after curat ive surgery. Complete repair should be done early (12 to 18 months) to reduce dysrhythmia and right ventricular hypertrophy. Corrective atri al surgery for transposition of the great vessels, a totally physiolog ical operation, has been replaced by anatomic correction, improving pr ognosis to more than 90% survival and only 10% reoperation rate. Surge ry for coarctation of the aorta gives very good results modulated by t he risk of recurrence, especially when performed early (before 6 month s). Medical-surgery management of hereditary cardiopathies begins at b irth. Surgery for all operable malformations should be performed befor e the end of the second year of life, allowing for nearly normal life, both at home and at school.