Standards for Centers Caring for Patients with Congenital Cardiac Defects

TI HE purpose of this report is to provide standards for services and niecessary equipment for centers responsible for the diagnosis and surgical care of patients with congenital defects of the heart and blood vessels. Skill in this field is dependent oni traininig and on continuous extensive experience which in turn is related to the caseload of an institution. Before establishing such a center, careful consideration should be given to the real need in the city or area for this highly specialized type of diagnostic workup and surgical correction. Many skills and facilities needed are not ordiniarily available outside a medical center. Accurate diagnosis of the congenital cardiac malformation is a prerequisite to cardiac surgery. To have a diagnostic center for this purpose is, therefore, of prime importance for any hospital in which cardiac surgery is performed. This type of work requires highly developed teamwork on the part of the pediatric or medical diagnostician, surgeon, anesthesiologist, roentgenologist and members of allied services. It is not advisable to have a sharp divisioii between diagnostic and surgical responsibilities. The center in which cardiac surgery is done must be approved for resident traininig in surgery and in internal medicine or pediatrics. It must be ultimately responsible for both definitive diagnosis and surgical care. The essential requirements for a diagnostic ceniter follow below.