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    <front>
        <journal-meta>
            <journal-id journal-id-type="publisher-id">rbccv</journal-id>
            <journal-title-group>
                <journal-title>Brazilian Journal of Cardiovascular Surgery</journal-title>
                <abbrev-journal-title abbrev-type="publisher">Braz. J. Cardiovasc.
                    Surg.</abbrev-journal-title>
            </journal-title-group>
            <issn pub-type="ppub">0102-7638</issn>
            <issn pub-type="epub">1678-9741</issn>
            <publisher>
                <publisher-name>Sociedade Brasileira de Cirurgia Cardiovascular</publisher-name>
            </publisher>
        </journal-meta>
        <article-meta>
			<article-id pub-id-type="doi">10.21470/1678-9741-2025-0167</article-id>
			<article-id pub-id-type="publisher-id">00005</article-id>
			<article-categories>
				<subj-group subj-group-type="heading">
					<subject>LETTER TO THE EDITOR</subject>
				</subj-group>
			</article-categories>
			<title-group>
				<article-title>Between Hearts and Gears: Technology at the Service of
					Life</article-title>
			</title-group>
			<contrib-group>
				<contrib contrib-type="author">
					<contrib-id contrib-id-type="orcid">0000-0002-2876-5967</contrib-id>
					<name>
						<surname>Duarte</surname>
						<given-names>Paulo Cesar</given-names>
						<suffix>Junior</suffix>
					</name>
					<degrees>PhD</degrees>
					<xref ref-type="aff" rid="aff1">1</xref>
					<xref ref-type="aff" rid="aff2">2</xref>
				</contrib>
				<contrib contrib-type="author">
					<contrib-id contrib-id-type="orcid">0000-0002-8794-8114</contrib-id>
					<name>
						<surname>Murakami</surname>
						<given-names>Alexandre Noboru</given-names>
					</name>
					<degrees>PhD</degrees>
					<xref ref-type="aff" rid="aff3">3</xref>
				</contrib>
				<contrib contrib-type="author">
					<contrib-id contrib-id-type="orcid">0000-0002-4859-5897</contrib-id>
					<name>
						<surname>Andrade</surname>
						<given-names>Aron José Pazin de</given-names>
					</name>
					<xref ref-type="aff" rid="aff1">1</xref>
				</contrib>
			</contrib-group>
			<aff id="aff1">
				<label>1</label>
				<institution content-type="normalized">Instituto Dante Pazzanese de
					Cardiologia</institution>
				<institution content-type="orgdiv1">Department of Bioengineering</institution>
				<addr-line>
					<named-content content-type="city">São Paulo</named-content>
                        <named-content content-type="state">São Paulo</named-content>
				</addr-line>
				<country country="BR">Brazil</country>
				<institution content-type="original">Department of Bioengineering, Instituto Dante
					Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil</institution>
			</aff>
			<aff id="aff2">
				<label>2</label>
				<institution content-type="normalized">Universidade Estadual de Londrina</institution>
				<institution content-type="orgdiv1">Department of Civil Construction</institution>
				<addr-line>
					<named-content content-type="city">Londrina</named-content>
                        <named-content content-type="state">Paraná</named-content>
				</addr-line>
				<country country="BR">Brazil</country>
				<email>duartejunior.pc@gmail.com</email>
				<email> paulo.duarte@dantepazzanese.org.br</email>
				<institution content-type="original">Department of Civil Construction, Universidade
					Estadual de Londrina, Londrina, Paraná, Brazil</institution>
			</aff>
			<aff id="aff3">
				<label>3</label>
				<institution content-type="normalized">Universidade Estadual de Londrina</institution>
				<institution content-type="orgdiv1">Department of Surgical Clinics</institution>
				<addr-line>
					<named-content content-type="city">Londrina</named-content>
                        <named-content content-type="state">Paraná</named-content>
				</addr-line>
				<country country="BR">Brazil</country>
				<institution content-type="original">Department of Surgical Clinics, Universidade
					Estadual de Londrina, Londrina, Paraná, Brazil</institution>
			</aff>
			<author-notes>
				<fn fn-type="edited-by">
					<label>Editor-in-chief</label>
					<p>Henrique Murad<ext-link ext-link-type="uri"
							xlink:href="https://orcid.org/0000-0002-9543-7832"
							>https://orcid.org/0000-0002-9543-7832</ext-link>
					</p>
				</fn>
				<fn fn-type="edited-by">
					<label>Associate Editor</label>
					<p>Leonardo Augusto Miana<ext-link ext-link-type="uri"
							xlink:href="https://orcid.org/0000-0001-5806-6780"
							>https://orcid.org/0000-0001-5806-6780</ext-link>
					</p>
				</fn>
			</author-notes>
			<!--pub-date date-type="pub" publication-format="electronic">
				<day>10</day>
				<month>12</month>
				<year>2025</year>
			</pub-date>
			<pub-date date-type="collection" publication-format="electronic">
				<year>2026</year>
			</pub-date>-->
			<pub-date pub-type="epub-ppub">
				<year>2026</year>
			</pub-date>
			<volume>41</volume>
			<issue>2</issue>
			<elocation-id>e20250167</elocation-id>
			<history>
				<date date-type="received">
					<day>13</day>
					<month>05</month>
					<year>2025</year>
				</date>
				<date date-type="rev-recd">
					<day>27</day>
					<month>05</month>
					<year>2025</year>
				</date>
				<date date-type="accepted">
					<day>3</day>
					<month>06</month>
					<year>2025</year>
				</date>
			</history>
			<permissions>
				<license license-type="open-access"
					xlink:href="https://creativecommons.org/licenses/by/4.0/" xml:lang="en">
					<license-p>This is an Open Access article distributed under the terms of the
						Creative Commons Attribution License, which permits unrestricted use,
						distribution, and reproduction in any medium, provided the original work is
						properly cited.</license-p>
				</license>
			</permissions>
			<counts>
				<fig-count count="0"/>
				<table-count count="0"/>
				<equation-count count="0"/>
				<ref-count count="6"/>
			</counts>
		</article-meta>
	</front>
	<body>
		<p>This letter is an invitation to reflect on the role of technology and interdisciplinary
			collaboration in addressing the challenges posed by congenital heart disease. It is not
			a defense of engineering, nor a glorification of technology. It is about recognizing
			that these tools, when guided by human and ethical purposes, have the potential to
			transform realities, especially those marked by anatomical complexity and clinical
			urgency.</p>
		<p>For decades, medicine has continuously reinvented itself. New surgical techniques,
			diagnostic advances, and safer therapies are part of this trajectory<sup>[<xref
					ref-type="bibr" rid="B1">1</xref>]</sup>. In parallel, other sciences such as
			engineering have quietly approached the field. Not with the intention of taking the
			place of the surgeon, but with a willingness to support, through simulations that
			anticipate scenarios, devices designed with precision, and three-dimensional
			representations capable of revealing what cannot be seen with the naked eye<sup>[<xref
					ref-type="bibr" rid="B2">2</xref>]</sup>.</p>
		<p>What has become common in industry, such as the use of robots to optimize production
			lines, is still developing in healthcare<sup>[<xref ref-type="bibr" rid="B3"
				>3</xref>]</sup>. Interestingly, in those sectors, automation has not reduced jobs.
			On the contrary, it has redefined roles, increased safety, and enhanced efficiency. Why
			not envision something similar in the hospital setting?</p>
		<p>The intention is not to elevate one science above another, but to build bridges.
			Engineering alone does not save lives. Medicine, by itself, continues to save many, but
			often at the cost of immense human and structural effort. True transformation arises
			from the intersection of knowledge. From continuous, institutionalized integration
			between specialties that, together, can anticipate problems, propose solutions, and
			expand access.</p>
		<p>Today, we can already envision a future where algorithms help to identify vascular
			geometries, simulate hemodynamics, predict risks, and suggest personalized
					treatments<sup>[<xref ref-type="bibr" rid="B4">4</xref>]</sup>. This is no
			longer science fiction. It is becoming a reality in centers that have chosen to
			integrate technical knowledge into clinical care. What we still lack is not technology,
			but vision. Vision to incorporate these tools critically, ethically, and with a
			commitment to equity.</p>
		<p>Above all, it is about broadening access. Planning technologies, innovative materials,
			predictive models, and simulation-based training should not be exclusive instruments,
			but tools that promote justice in healthcare. The true impact of innovation occurs when
			it reaches those who need it most, shortening the distance between diagnosis and
			intervention, between technical knowledge and family relief.</p>
		<p>A few months ago, a study based on three-dimensional numerical simulations applied to the
			Fontan procedure was published in this journal<sup>[<xref ref-type="bibr" rid="B2"
					>2</xref>]</sup>. More recently, in Medical Engineering &amp; Physics, this
			approach was further developed through a multiparametric analysis of the total
			cavopulmonary connection<sup>[<xref ref-type="bibr" rid="B5">5</xref>]</sup>.
			Additionally, artificial intelligence was used to map critical gaps in the literature on
			pediatric implantable devices, revealing neglected areas<sup>[<xref ref-type="bibr"
					rid="B6">6</xref>]</sup>. These examples demonstrate that integration between
			engineers and physicians is not just desirable, it is necessary.</p>
		<p>Such technologies do not aim to replace human hands, but to strengthen them. They do not
			intend to dictate conduct, but to support decision-making. They represent a way to
			multiply accumulated knowledge, to train new professionals in safe environments, and to
			improve surgical outcomes through robust preoperative analysis.</p>
		<p>No surgery is performed in isolation. There is always a team. Perhaps it is time to
			broaden the meaning of that word, including specialists from other areas: computer
			scientists, biomedical engineers, mathematicians, physicists. Not to interfere with
			clinical judgment, but to contribute to its preparation, safety, and effectiveness.
			Genius today does not lie in solitary specialization, but in the solidarity of
			intersecting worlds.</p>
		<p>We would like to conclude with an image: a silent operating room, surrounded by screens
			displaying flows, pressures, geometries, and probabilities. At the center, a dedicated
			team, making decisions based on data, but guided, above all, by an unwavering
			conviction, that every heartbeat is a universe worth protecting. May technology never
			lead us to forget this essential truth.</p>
	</body>
	<back>
		<sec>
			<title>Artificial Intelligence Usage</title>
			<p>The authors declare the use of ChatGPT (OpenAI) solely for language editing and text
				refinement. All scientific content, including conception, methodology, results, and
				interpretations, is the authors’ own work. The final manuscript was thoroughly
				revised and validated by the authors, who take full responsibility for the published
				content.</p>
		</sec>
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</article>
