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Improvements in the surgical and medical care of infants and children with congenital heart disease are one of the most spectacular medical success stories of the past quarter-century. Diseases such as simple D transposition, truncus arteriosus, and critical aortic stenosis are no longer highly efficient killers of infants; now nearly all children with these conditions survive, and the medical focus has shifted from decreasing mortality to improving the status of long-term survivors. Even the lesion most resistant to therapy, the hypoplastic left heart syndrome, has many survivors thanks to recent advances.
Central to these stunning successes is a broad and
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