Introduction

Abstract

This issue of the pediatric cardiac surgery annual is one of our most ambitious ever. We have tried to assemble a diversity of information with the anticipation that we will be providing the reader with a collection of articles that will be a resource for several years to come. We are grateful to the numerous contributors for working with us to meet a very tight deadline and submitting such high-quality work within a restricted time frame. We remain indebted to Jill Shepherd at Elsevier for her outstanding editorial support and advice and are thankful to Amy Cline at OHSU for her efforts over 2 years to provide us with a consistent and outstanding administrative presence. We have divided this issue into several sections. The first addresses important innovations in our techniques of cardiopulmonary bypass and perioperative management. We are convinced that some of our improvement to outcomes in the future will occur as we further refine and understand the systems that we expose our patients to in and out of the operating room. In the section on Innovative and Complex procedures, we have assembled contributions from numerous outstanding contributors in our field that provide information for dealing with challenging defects or patient groups. For HLHS, we have concentrated on the evolving management strategy that uses avoidance of CPB for neonatal palliation by using various approaches to create control of pulmonary blood flow and security of systemic blood flow. We have also included two articles related to treatment of AV discordance because this defect underscores our need to train future surgeons in atrial switch operations—a procedure that many young surgeons have never seen. Evaluation of outcomes after congenital heart surgery is becoming increasingly important and will most likely become a major focus of how we evaluate our work in the future. Significant work is being performed to help us all understand the quality of our care for those patients who survive us, and surgeons are becoming increasingly aware that they are part of a much larger system of overall care for a patient with congenital heart disease. We have included two pro-con issues by surgical colleagues who were intrepid enough to try and defend a position. We are aware that it is by acknowledging these controversies that we can stimulate the imagination and the ability to create that has long been a hallmark of our profession in the hopes that we can provide solutions to current limitations. A short article on a modification of the Ross procedure designed to eliminate the possibility for autograft dilatation is appended to the debate on the Ross procedure to emphasize this. Finally, we have included the vast amount of information that was collected at the recent combined meeting of the Congenital Heart Surgeons Society (CHSS) and the European Association for Congenital Heart Surgery (EACHS) relating to practice patterns for a variety of important issues as indicated using an audience response system that can improve the reliability of the information by ensuring anonymity of response. In closing, we are grateful to Richard Jonas for inviting us to guest edit this edition. It provided us with the opportunity to select and present you with this information. Enjoy.