Minimally invasive pediatric cardiac surgery

Minimally invasive cardiac surgery has evolved in response to the intrinsic irony facing cardiac surgeons: that we must injure our patients to treat t hem. In recent years, advances in fiberoptic imaging technology, applied to other surgical specialties, suggested the possibility that cardiac surgery might also be performed endoscopically. The anatomic and spatial constrain ts of pediatric cardiac surgery, and its dependence on extreme levels of sp eed, precision, and three-dimensional perception, made the application of r emote, two-dimensional operating systems seem impossible, or at least impru dent in this special group of patients. Despite these limitations, however, applications of video-assisted endoscopic surgical techniques have been de monstrated to allow the safe and effective performance of an expanding rang e of operative procedures in congenital heart surgery. The guided developme nt of new technology will accelerate this process in the coming years.