Myocardial Protection

One of the most important fundamental differences between surgery for congenital heart disease versus surgery for acquired heart disease is the fact that both the myocardium and the coronary arterial tree are normal in the vast majority of patients with congenital heart disease, particularly in neonates and infants. The congenital cardiac surgeon is not confronted by the difficult problems of uniform delivery of cardioplegia solution, focal areas of scar and global severe impairment of ventricular function. In fact, a fundamental premise of this book is that congenital cardiac surgery should be undertaken early in life before the myocardium has been deleteriously affected by the congenital heart problem in question.