Congenital Heart Defects Decision Making for Cardiac Surgery Vol
Expressly created to assist with decision making for surgical treatment of congenital heart defects, this new reference covers all relevant aspects. The congenital heart defects are presented with each chapter devoted to a single malformation, with incide
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I Congenital Heart Defects Decision Making for Cardiac Surgery Volume 1 Common Defects
Dedicated to my loved children Federica, Laura and Jonathan
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Congenital ea rt Defects Decision Making for Cardiac Surgery
Volume 1
Common Defects
Foreword by LUDWIG K. VON SEGESSER With 123 Figures in 296 Separate Illustrations
Springer
ISBN 978-3-642-57358-3 (eBook) ISBN 978-3-642-63245-7 DOI 10.1007/978-3-642-57358-3
f oreword
Nature has the very special property to reproduce itself in unlimited variations. That is the main reason why we are all somewhat different from each other, and it is considered by some, as one of the essential faculties that allows for continuous evolution. However, natural differentiation can go a little bit and sometimes even too far. Occasionally, as one of the results, all sorts of congenital heart defects do occur in a multitude of expressions and combinations. It is interesting to note here that relatively minor congenital heart defects can become rapidly quite symptomatic and are therefore readily recognized and treated. On the other hand, major defects can appear almost compensated, and may remain hidden for a long time until secondary changes can preclude a usually promising therapeutic approach. Phenomena such as those described can become a major issue for patients with congenital heart defects, their families, and their doctors. In an ideal world, the diagnosis of congenital heart defects should be made before birth, and the same holds true for the therapeutic strategy which can be established before delivery, in order to be able to provide the best possible care at birth if necessary, or for a more futuristic scenario even in utero whenever possible. However, for the time being, such an early approach is far from being the standard on a global scale, and the major number of patients with congenital heart defects are still referred relatively late to institutions with the required expertise for adequate diagnostics, initial treatment, and follow-up. Access, or better, lack of access to appropriate medical facilities is certainly the predominant problem in this respect for remote areas. But even in the urban environment, where many of us do live, there are patients in need of adequate care despite the fact that the necessary facilities exist, and the social security system is set up to bear the cost generated. This somewhat surprising situation has certainly various reasons. One plausible explanation is that the great variability of congenital malformations did not allow until now to have for all these different diagnoses well-established protocols for diagnostics, and also so for treatment and decision making. The list of diagnoses established by the European Society of Pediatric Cardiology lists 2000 congenital cardiac diagnoses, which can occur isolated or combined. Even the short list has about 100 positions, which all deserve careful attention. To make things more complicated, the presence of congenital heart disease does not preclude other mal
