Surgical successes in newborn infants with critical cardiac defects challenge pediatricians, pediatric cardiologists, and thoracic surgeons to recognize, diagnose, and correct these lesions. The report of Varghese and his colleagues documenting the management of 100 consecutive infants with apparently life-threatening cardiac malformations will be of interest to all concerned. Such newborn infants present formidable problems. The difficulties of recognizing which infant has a naturally fatal lesion, the suddenness and rapidity with which the clinical course may shift downwards, the logistics of transferring a sick infant to a center equipped and staffed for emergency cardiac catheterization and emergency surgery, the technical difficulties of miniaturizing equipment for cardiac catheterization and cardiac surgery, and the inherent risks of diagnostic catheterization and cardiac surgery in seriously ill babies are sobering obstacles.