Changing trends in cardiac disease and cardiac surgery.

The trends in cardiac surgery during the four decade or so life history of this specialty have been inexorably toward progress--a greater capacity to relieve suffering and to prolong life for patients afflicted with cardiac disease. It has been a team effort, led by a professional coalition of cardiologist, cardiac anaesthetist, cardiac pathologist and cardiac surgeon, but also with major involvement of nursing, technical and supporting specialties. As technology and capability have progressed and will continue to do so, the challenge for the future, both professionally and socio-economically, will increasingly be our capacity to deliver this demanding, sophisticated and expensive care to expanding proportions of aging individuals, creating a problem which can ultimately be met only by new knowledge and new disciplines of prevention.