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Clinical pediatric cardiology

The importance of understanding the development of the normal heart as a prelude to defining structural abnormality is the clear message of Professor Anderson's anniversary review. A better understanding of the difficulties of the Fontan procedure undertaken in hearts with one functioning ventricle forms the basis of communications concerning the various technical approaches to this procedure and leads to a discussion of one approach which leaves a controllable residual atrial septal defect. Increasing longevity following many major cardiac procedures has led to a new population of adolescents and young adults requiring expert medical and surgical attention, as detailed in a Bethesda conference, which also covered important social issues germane to this population. The recent identification of the connective tissue abnormality in Marfan syndrome, referred to as the aortic root abnormality, may help in understanding the later complications of this syndrome and underlines the need for cooperation between cardiologists involved in the care of these patients in childhood and those involved in later life.