"Baby Heart Project": the Italian project for accreditation and quality management in pediatric cardiology and cardiac surgery.

Optimization of the relationship between the supply and the demand for medical services should ideally be taken into consideration for the planning within each national Health System. Although government national health organizations embrace this policy specifically, the contribution of expert committees (under the scientific societies' guarantee in any specific medical field) should be advocated for their capability to collect and analyze the data reported by the various national institutions. In addition, these committees have the competence to analyze the need for the resources necessary to the operation of these centers. The field of pediatric cardiology and cardiac surgery may represent a model of clinical governance of particular interest with regard to programming and to a definition of the quality standards that may be extended to highly specialized institutions and ideally to the entire Health System. The "Baby Heart Project," which represents a model of governance and clinical quality in the field of pediatric cardiology and cardiac surgery, was born from the spontaneous aggregation of a committee of experts, supported by duly appointed Italian Scientific Societies and guided by a national agency for accreditation. The ultimate aim is to standardize both procedures and results for future planning within the national Health System.

Conservative treatment of postoperative chylothorax with octreotide.

Chylothorax is a rare but serious and well-recognized complication of general thoracic and cardiac procedures. No new invasive or non-invasive definitive therapies are available. This article reports the case of a 67-year-old woman who underwent myocardial revascularization and who developed a postoperative chylothorax necessitating continuous drainage and conservative management. When after 1 week this treatment still had not resolved the chylothorax, octreotide was instituted, leading to a rapid cessation of chyle production and rendering surgical management of this complication unnecessary.