In this issue, Siblini et al. [1] reported successful transcatheter guidewire perforation and balloon pulmonary valvuloplasty in a newborn with membranous pulmonary valve atresia with intact ventricular septum. In addition, the authors courageously implanted a 4mm coronary stent into the ductus arteriosus to maintain patency when a surgical aortopulmonary shunt was imminent. After a one year follow-up, the patient is doing well with an O 2 saturation of 85%, a near normal sized right ventricle, a tricuspid valve with a Z value of ϩ1.4, and a pulmonary valve with a Z value of ϩ0.8. In addition, there was no significant transvalvar Doppler gradient (Ͻ1.2 m/sec), only mild pulmonary insufficiency, a small left-to-right PDA shunt, and a small volume of right-to-left flow through a patent foramen ovale. Plans are to eventually close the PDA and PFO using transcatheter devices, without a surgeon's scalpel in sight! Whew!!! Should we throw rocks or toss roses? Since this is a catheterization journal, I believe that red is a suitable color for Dr. Rao and his group.
Before we go too much further with accolades, however, I must give credit where credit is due. In 1978, a debonair young pediatric cardiology fellow from Caracas, Venezuela, by the name of Richard Gibson was training with Larry Latson and myself in Houston, Texas. He was trying to convince Dr. Chuck Mullins to use his ''new'' transseptal needle to perforate the valve in neonates with pulmonary valve atresia and intact ventricular septum. Even Chuck thought this was a bit too risky, so Richard was relegated to that crazy fellow with a great smile and funny accent (he didn't speak Texan very well) who thought the aorta ''siphoned'' the blood from the heart and was willing to skewer a newborn with a long, stiff, sharp catheter needle! Well, Richard, we all owe you an apology. As usual, some free-thinking and daring pediatric cardiologist from outside the United States was leading the way. In 1991, Qureshi et al. [2] first described laser-assisted balloon pulmonary valve dilation of an atretic pulmonary valve in Guy's Hospital, London. Also in 1991, Larry Latson used Richard's vision and reported the first successful transmembrane guidewire perforation and balloon valvuloplasty in a newborn with this disease in our institution [3]. By the way, this healthy little girl is now 7 years old, having undergone a second