Leaving neverland: a randomized trial for coarctation shows pediatric interventional cardiology is growing up.

Coarctation of the aorta is commonly considered a relatively simple form of congenital heart disease. On the basis of early knowledge of the significant mortality associated with unrepaired coarctation, surgical therapy was first developed and performed in the mid-1940s.1–3 In many ways, the seemingly simple problem of pediatric coarctation has lent itself to a myriad of treatment strategies, including transcatheter intervention. The community of pediatric cardiologists and cardiac surgeons, faced with these broad options, has failed to reach consensus about optimal management. Even 12 years after publishing the early results of a randomized trial comparing angioplasty with surgery in the treatment of children with coarctation, Cowley and colleagues continue to acknowledge the ongoing and active controversy surrounding the topic.4,5