Pediatric cardiac surgery.

Although there is fair agreement in many areas of pediatric cardiac surgery, issues of controversy and uncertainty persist. The role of the Fontan procedure in the treatment of complex congenital heart lesions is expanding, mainly by necessity, because an alternative biventricular repair is often not available. Reports on medium- and long-term results after Fontan's operation clearly demonstrate the palliative nature of the procedure, even in good candidates, and do not seem to support the widening of its indications. The purpose of this paper is to highlight this controversy, as well as to report on the state of affairs in the treatment of hypoplastic left heart syndrome, transposition of the great arteries, and tetralogy of Fallot.