1 Associate Professor of Pediatrics Director, Pediatric Cardiac Clinic, Stanford University, Palo Alto, California 94394
The "controversy" over treatment of infants with ventricular septal defects published in the January 1967 issue of Pediatrics prompts me to comment on one general factor, vital in decisions between alternative methods of treatment of congenital heart disease, which has received little attention in the literaturenamely, the experiences and capabilities of individual surgical teams. That Dr. Nadas takes this into account is reflected in his statements, ". . . our surgeons have been able to accomplish [banding of the pulmonary artery] at a mortality rate of 10% or less . . ." and ". . . the pediatrician unless he has surgeons with exceptional ability at his disposal, will do better to . . . proceed conservatively."