Drs. Greenwood and Nadas Reply

Abstract

Speed of referral for cardiac evaluation, accuracy of diagnosis, and parental and physician attitudes have changed in the last few years, resulting in more aggressive intervention in the infant with congenital heart disease and Down's syndrome. The study reported in Pediatrics reviews the "clinical course" at a major cardiac referral center, which during the years noted neither denied care nor aggressively intervened in babies with multiple anomalies. Many children in the review were not operated on and at the time of entry into the center should not have been.