J Perloff. Congenital Heart Disease In Adults: A Historical Perspective. The Internet Journal of Cardiology. 2002 Volume 2 Number 1.
It is uncommon if not rare for a new area of specialized cardiovascular interest to appear on the scene, but such has been the case with
Beginning in the mid 19 th century, a series of events prefigured a brighter future. Within the span of four years--1842 to 1846—anesthesia was born in the United States and ranks among America's greatest contributions to medicine. In 1895, Konrad Roentgen discovered “a new kind or rays,” and in 1937, Castellanos, Pereias and Garcia in Cuba, and Robb and Steinberg in New York independently developed angiocardiography. “The internal structure of the living heart had been revealed for the first time.” Willem Einthoven of Leiden developed the string galvanometer and in 1903, constructed the first electrocardiograph. In 1929 at the Augusta-Viktoria Hospital in Eberswalde near Berlin, Werner Forsmann, only a year after finishing his medical studies, performed the first cardiac catheterization on a living human being---himself. The untiring work of Maude Abbott culminated in her 1936
Medical ultrasound was introduced in the 1960's, and before long, cardiac ultrasonography was heralded as “the diagnostic pathway to the promised land.” Echocardiography soon provided accurate, safe and painless diagnostic information from fetal life to the neonate, child, adolescent and adult with congenital heart disease.
Cardiac catheterization as a therapeutic intervention had its inception in 1966 with Rashkind's creation of an atrial septal defect without thoracotomy as a palliative approach to complete transposition of the great arteries.
Immense technical resources are now at our disposal, permitting remarkably precise anatomic and physiologic diagnoses and astonishing feats of palliative and reparative surgery. Survival patterns have been affected, often profoundly. Approximately 85% of infants with congenital heart disease in developed countries can expect to reach adulthood. In the United States, there are currently approximately 900,000 to a million adults with complex, moderately complex and simple congenital malformations of the heart, and 20,000 open operations are performed annually. Although cardiac surgery and interventional catheterization have revolutionized survival patterns, cures in the literal sense are few. Postoperative residua and sequelae are the rule, and range in severity from inconsequential to serious. Importantly, even curative cardiac surgery does not preclude noncardiac residua, some of which have major impacts on morbidity and longevity.
The care of adults with congenital heart disease requires knowledge of the basic malformation
The first publication to characterize the changing population of congenital heart disease was exactly 30 years ago--Circulation March 1973, the