Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code (IPCCC) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases (ICD-11). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC.

The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature. This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature.

The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC, as IPCCC continues to evolve.

To the student of comparative constitutional law the new Prussian constitution of November 30, 1920, is of scarcely less interest than that of the reconstituted German Empire itself. In sharp contrast to American state constitutions, the instrument is of moderate length, about four thousand words, and is limited to the bare outlines of a frame-work of government. All doctrinaire elements are lacking. There is even no bill of rights.

To understand the real nature of the government which now, under its new constitution, is attempting to guide the German nation through the perils of reconstruction is indeed a baffling problem. We are as yet too close to the events which brought it into existence and clothed it with constitutional forms to attempt their evaluation or to determine their significance. The revolution was so unlike what we should have expected as necessary to shift the ultimate power in the state from a narrow military and landed oligarchy to the masses of the people, that a doubt forces itself upon us as to its genuineness. The war, with its shattering of national ideals, its appalling toll of life, the grinding misery which it imposed, and the insuperable financial bondage to which it condemned the nation for an indefinite future, might account for a thorough popular disillusionment which would sweep the nation into the current of democracy. But if this were the case, we would expect a general enthusiasm for the new government, an evident popular sense of the passing of the dark night of autocratic rule and a joy in the light of a new and happier day.

This is exactly what does not exist. There are three classes in Germany today. The first, who constitute only a small minority, are the nationalists and militarists who are bitterly opposed to the republic, and even now are agitating at every favorable opportunity for the restoration of the monarchy in its old form. The second class are likewise a comparatively small minority. They are the revolutionaries, the Spartacists with some of the Independent Socialists, who are just as strongly opposed to the government, using wherever possible the instruments of direct action to inaugurate the revolution which they believe has not yet been achieved. The vast mass of the nation appear to be utterly indifferent with respect to forms of government.

The revolution in Germany strikes the observer as different in essential respects from revolutions which have taken place in other countries. One looks, in such events, for a few short days of blood and battle; for power wrested by force from the grip of those who have held it; for popular turmoil, the citizenry waging conflict behind street barricades against the disciplined but gradually disintegrating and increasingly disaffected troops of the established government—in short, for a journée in which the overturn is speedily accomplished and the new régime quickly set up. But the German revolution affords no such spectacle. There has been, to be sure, street-fighting and bloodshed, but they have been incident to the attempt of the extremists to overthrow the revolutionary government or to compel it to undertake a more radical program. The revolution itself was bloodless, and the establishment of the provisional government under Ebert was only the last step in a crumbling process which had been evident during the latter part of the administration of Count von Hertling and the whole of that of Prince Max.