Pediatric cardiac surgery: Past, present, and future

Congenital heart defects (CHDs) are the leading congenital anomalies in humans, with approximately 1.3 million worldwide cases each year. In the past, they were one of the leading causes of infant mortality, and only 15% of patients in the 1940s and 1950s reached adulthood. Today, a profound shift in survival rate has occurred thanks to technological advancements, a deeper understanding of these conditions, early diagnosis capabilities, and neonatal surgery, with 90-95% of newborns with CHD reaching adulthood. The future of CHDs looks promising, with genetic and epigenetic discoveries enabling personalized treatments and improvements in the management of long-term complications. Tissue engineering and regenerative medicine could revolutionize treatment, with the creation of custom-made heart valves and vascular tissues, as well as cellular therapies to improve myocardial function, along with potential solutions for complete heart replacement in cases of myocardial failure. The future challenge remains ensuring that children born with CHDs not only have a long life but also a quality of life comparable to that of all other children.