Analysis of factors which might improve the survival rate of infants with congenital heart disease.

During 1973--1977, 212 infants underwent open heart operations for congenital heart disease at the Thoracic Unit, The Hospital for Sick Children, Great Ormond Street. The current results (75% survival rate) are compared with the results from earlier years (1963--1967) which showed only a 35% survival rate. Two groups are discussed in detail: Infants with Total Anomalous Pulmonary Venous Drainage, and Persistent Truncus Arteriosus. Although the operative risk in both groups remains high, the analysis of the natural history, palliative and corrective surgery and causes of death suggests that early total repair of severely symptomatic infants achieves the optimal results. The importance of careful analysis is emphasised. Palliative surgery still plays an important role in the treatment of congenital heart defects in infancy. The optimal timing and time of operation can only be selected after careful analysis of various factors.