Antonio F. Corno1, Cynthia Liu2
1Research Professor, Houston Children’s Heart Institute, Memorial Hermann Children’s Hospital, University Texas Health, McGovern Medical School, Houston, Texas, USA; 2TP Editorial Office, AME Publishing Company
Correspondence to: Cynthia Liu. TP Editorial Office, AME Publishing Company. Email: editor@thetp.org.
Editor’s note
Translational Pediatrics (TP) has published a number of special series in recent years, receiving overwhelming responses from academic readers around the world. Our success cannot be achieved without the contribution of our distinguished guest editors. This year TP launched a new column, “Interviews with Guest Editors”, to better present our guest editors and to further promote the special series. We also hope to express our heartfelt gratitude for their tremendous effort and to further uncover the stories behind the special series.
The special series “Pre-natal Diagnosis in Congenital Heart Defects”(1) led by Prof. Antonio F. Corno (Figure 1) from the McGovern Medical School has attracted many readers since its publication. This special series aimed to collect and share with the readers of “Translational Pediatrics” the current state-of-the-art knowledge on pre-natal diagnosis in congenital heart defects, with the updated information provided by the world experts in this matter. At this moment, we are honored to have an interview with Prof. Antonio F. Corno to share his scientific career experience and insights on this special series.
Figure 1 Prof. Antonio F. Corno.
Expert introduction
My professional career has been focused on the surgical treatment of congenital heart defects. The clinical experiences moved me through hospitals in different countries and continents, such as Italy, where I received my medical education at the Universities of Pavia, Padova and Siena, then for my training in the Netherlands at the University of Amsterdam, and in Los Angeles at the University of California, and then to work in European countries such as France, Scotland, Switzerland, England, in Middle East (Saudi Arabia), in Far East (Malaysia), England again and North America (Texas, United States). Simultaneously to the clinical activities, in many places I had the opportunity of having academic commitments, dedicating time and energies to education, including the role of Professor in Leicester, England, and in Houston, Texas, USA.
Everywhere I worked, I also performed experimental and clinical research activities, with a long list of projects, always focused on congenital heart defects.
All the above clinical and research activities resulted in a remarkable large number of publications, including books, chapters for books, original and review articles, and editorial commentaries. This provided me the opportunity of several editorial roles in international journals, with initiatives of Special Series on congenital heart defects.
Interview
TP: What motivated you to specialize in pediatric cardiology?
Prof. Corno: From the medical school I was always fascinated by the heart, unique organ of our body, with spontaneous activity continuing for all our life, great capability of adapting to various physical and psychological demands, and a mechanical efficiency far superior to any mechanical pump designed by human beings. The heart has a much better mechanical performance than any machine in terms of efficiency, energy consumption, and space occupation. It was then unavoidable to be attracted by the congenital heart defects, with a huge spectrum of various forms and functions, including very complex malformations, challenging the caregivers. At the beginning of my career, in the books of pediatric cardiology and cardiac surgery many of the heart malformations were simply considered inoperable. This was for me unacceptable, and therefore this challenge became a fatal attraction, which followed me for all my professional life. In addition, because of my work, the encounters with children affected by congenital heart defects were transformed in relationships with their extended families, and these human aspects in most of the cases accompanied me for many years, despite my moving through different countries and continents.
TP: Thank you for editing the special series “Pre-natal Diagnosis in Congenital Heart Defects” for TP (1). Could you please introduce to us which part of the content impressed you most in this special series? Compared with other similar projects, what do you think are the unique advantages of this special series?
Prof. Corno: A peculiar aspect of this special series on “Pre-natal Diagnosis in Congenital Heart Defects” is the fact that all authors invited to submit their contributions, not only confirmed to be world authorities in their specific fields of expertise, but showed their passion and motivation in pushing the boundaries of the available knowledge, dedicating their research to improve the current management of children with heart malformations in order to provide them with a better quality of life for their future.
The availability of this special series to the readers will certainly be useful to all people involved with the care of children with congenital heart defects to help them and their families.
TP: As you mentioned in the special series that “For congenital heart defects the progress of surgical treatments allowed a huge proportion of these children to reach adult life with a decent quality of life and social integration.”(2) Could you share with us the recent advances in surgical treatments of congenital heart defects?
Prof. Corno: The management of congenital heart defects in the last decades has received substantial benefits for the entire treatment, starting from the pre-natal diagnosis, through the entire peri-operative period, until the late follow-up.
Progresses in the knowledge, accompanied by improved technologies, allowed a degree of precision in the diagnosis, with 3D imaging available for the design of the best type of surgical approach, tailored to the unique complexity of each heart malformation. The same progress happened for the management of general anesthesia and cardiopulmonary bypass, nowadays maintaining a level of homeostasis for the entire operation unthinkable years ago, and therefore allowing the surgeons to focus on the surgical techniques to achieve the best possible repair, without any time constrain, as before. The early and late post-operative management also dramatically improved, due to the increased knowledge of the pathophysiology following surgical interventions, and to modern types of assistance for failing organs or systems in the body.
The most evident proof is that many of complex congenital heart defects, in particular the group of “functionally” single ventricles, considered inoperable few decades ago, are now surgically managed with positive outcomes, totally unexpected before.
TP: Over the past 50 years, pediatric medicine has increased its understanding of the pathogenetic causal mechanisms of congenital heart defects as well as its treatment, and any resultant sequelae. Looking towards the future, what do you believe is the most important direction for the study of pediatric cardiology? Specifically, what areas of research or treatment do you think hold the greatest promise for improving outcomes for patients?
Prof. Corno: The future research projects will be focused on the coming years probably in several areas.
In the fields of genetics major progresses have already allowed linking many heart malformations with genetic disorders, and this not only facilitate a pre-natal diagnosis, but open the pathways to researchers involved with genetic engineering studies.
The development of very accurate imaging modalities, and particularly the simultaneous combination of them, will allow the fusion of the 3D images provided by different modalities, and precise information for the surgeons to design the surgical approaches with an accuracy far better than ever before.
The research studies of new materials, bioengineered prosthetic tissues to use during the surgical procedures, will constitute another step forward.
Finally, the recent advances reached in the organ xenotransplantation, will soon or later make organs available to replace hearts either with too severe congenital malformations or poor function.
TP: Is the topic of this special series associated with any of your recent research projects? Would you please share some significant research you are working on?
Prof. Corno: As researcher and surgeon, I was always involved with the progresses of the pre-natal diagnosis, but one aspect I particularly concentrated on in the last few years is the ethical and social aspects of the pre-natal diagnosis. To know from the early pregnancy that the fetus has a congenital heart defect, especially when this is a complex malformation, carries endless implications not only for the medical and technical management of the fetuses, but for their parents, and extended families. This issue is approached in completely different ways in different institutions and countries, because of the differences in education, culture, religion, resources, and this is accompanied by totally different outcomes, with very deep and serious ethical implications.
TP: If given an opportunity to update this special series, what would you like to moderate, add or emphasize to provide a more comprehensive series?
Prof. Corno: Considering the very rapid progresses in the field of pre-natal diagnosis of congenital heart defects, it would be probably advisable to reorganize a similar exercise every 5-10 years.
Reference
- Pre-natal Diagnosis in Congenital Heart Defects. Available online: https://tp.amegroups.com/post/view/pre-natal-diagnosis-in-congenital-heart-defects
- Corno AF. Ethical issues after pre-natal diagnosis. Transl Pediatr 2021;10(8):2235-2240.