Pediatric cardiac surgery and cardiology care have been transformed during the past 3 decades by tremendous innovation and steady improvements. Relentlessly, the pediatric cardiac care community has pushed the envelope of what can be done to previously unimagined limits, and this is to be celebrated. Yet, with expanding capabilities come increasingly demanding choices. The key question is how to enlarge the envelope of care so that children (and their families) receive technically outstanding care in the context of ongoing decision support so that we provide all that should be done for the patient without crossing a line—admittedly, and yet also essentially, a line based on judgment—and lapsing into doing merely what, technically, can be done to the patient.
Figure. Concurrent complementary modes of care. Adapted with permission from Johns Hopkins University Press.8
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