Abstract
The ability to correct complex congenital heart defects surgically has improved considerably. However, several factors can adversely affect outcome in neonates, infants, and children undergoing cardiac surgery. The purpose of this review is to discuss important advances in coagulation, cardiopulmonary bypass, echocardiography, and cardiac catheterization. The effects of aprotinin, a proteinase inhibitor, on platelet preservation, aggregation, and postoperative blood loss is described. The physiology and effects of deep hypothermic circulatory arrest are compared with low-flow cardiopulmonary bypass. The value and feasibility of echocardiography with an update on interventional cardiology is discussed.
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