Congenital Heart Surgery Nomenclature and Database Project: palliation, correction, or repair?

Background: Inconsistent use of the terms palliation, repair, and correction, fosters unclear thinking about the goals of cardiac operation. Actual usage of these terms has not been previously documented.

Methods: Every article, for two years, pertaining to congenital heart disease in The Annals of Thoracic Surgery and The Journal of Thoracic and Cardiovascular Surgery was systematically inspected for terms of classification.

Results: In the 301 articles reviewed, repair and correction were used virtually interchangeably. Palliation was generally used distinctively, but all 3 descriptors were used for 3 operations. The etymology of each descriptive term suggests that they have distinct traditional definitions and connotations. Repair suggests returning to normal that which was once normal, while correction carries no implication of prior normalcy; thus, correction is the more etymologically correct term for congenital heart operations. In current literature, palliation is used improperly for a few operations to denote lack of anatomic correction or lack of permanence of correction.

Conclusions: Because proper usage reflects both etymology and actual usage, we suggest that repair and correction may be used interchangeably. Palliation, however, should describe only operations that are not intended to provide normal cardiac physiology.