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This narrative review examines the potential applications of artificial intelligence (AI) in pediatric and congenital heart surgery, focusing on improving diagnosis, risk assessment, perioperative planning, and clinical decision-making. It highlights the promise of machine learning, deep learning, and large language models in analyzing complex clinical and imaging data to improve diagnostic consistency and prioritize high-risk patients. The review emphasizes the need for ethical frameworks and multi-center validation to ensure safe and responsible AI integration in this vulnerable population.
AI tools hold promise for improving diagnostic accuracy and risk stratification in pediatric and congenital heart surgery, but widespread clinical adoption requires further validation and adherence to ethical guidelines.
Artificial intelligence (AI) is expected to transform pediatric and congenital cardiac surgery by enhancing diagnosis, refining risk assessment, optimizing perioperative planning, and supporting clinical decision-making. In congenital heart defects, the complexity and diversity of conditions, combined with the scarcity of specialist expertise, create a strong case for AI integration in regeneration and repair. Advances in machine learning, deep learning, and large language models offer the potential to analyze multimodal clinical and imaging data at scale, identify patterns beyond human detection, and deliver timely, personalized recommendations. Early applications in imaging, telemedicine, and decision support demonstrate promising performance, particularly in improving diagnostic consistency and prioritizing high-risk patients for intervention. However, most artificial intelligence tools remain at the prototype stage, with limited multi-center validation and challenges in generalizability, interpretability, and data quality. Ethical and governance frameworks, such as the FUTURE-AI consensus, emphasize fairness, transparency, and robustness as essential for safe deployment, especially in vulnerable pediatric populations. This review outlines current and emerging applications of AI in the care and repair of pediatric and congenital heart defects, highlights opportunities for improving outcomes and equity, and discusses the critical steps needed for responsible, clinician-led integration of artificial intelligence into surgical and perioperative practice.
