Publication:

The next era in pediatric cardiology: from lesion-based repair to precision, prediction and lifelong care

Pediatric cardiology is evolving from a disease-oriented model to a more precision-oriented, predictive, long-term follow-up-oriented and practically implementable discipline across care settings. With congenital heart disease (CHD) present in approximately 1% of live births, an increasing number of children and adults are living with heart defects that have been completely repaired, incompletely repaired, palliated, or medically managed. This review follows the child’s heart from fetal diagnosis and newborn detection through precise diagnosis, intervention, prediction of late outcomes, neurodevelopmental monitoring, transition to adult CHD care and prevention of acquired cardiovascular disease. New strategies, including updated algorithms for critical congenital heart disease screening, fetal cardiac programs and selected interventions, exome/genome sequencing, 3D surgical planning, catheter-based PDA closure in infants weighing ≥700 g, ductal stenting versus shunting, AI-assisted ECG and imaging analysis, wearables for heart failure monitoring, neurodevelopmental guidance, transition programs and global surgical quality registries, will only have value when matched to a specific patient, setting, threshold, owner, action and limitation.