Cyanotic congenital heart disease.

The last 15 years have witnessed a very remarkable change in the attitude of the clinician towards cyanotic congenital heart disease. It is within the memory of many that it was the custom to make a simple diagnosis of congenital heart abnormality with cyanosis, and express the opinion that little or nothing could be done about it. Then there appeared the pioneer work of Abbott and others which produced not only a classification of the various abnormalities, but furnished a mass of clinical and postmortem observations from which it was possible to build up a clinical picture and so arrive at a reasonably correct anatomical diagnosis. At the same time knowledge of the natural history of congenital heart disease has also increased, and some idea of its prognosis has been ascertained. Lastly, the conception of Taussig that an inadequate pulmonary blood supply was the critical abnormality in many cyanotic cases, and the development of an anastomotic operation between the systemic and pulmonary circulations so as to furnish an artificial ductus arteriosus, by Blalock