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efforts to treat babies with hypoplastic left heart syndrome began over 30 years ago, when surgeons first reported limited success with palliative surgery. cayler et al. performed an anastomosis between the ascending aorta and the right pulmonary artery, bilateral banding of the pulmonary arteries, and an atrial septectomy. their follow-up extended for only 7 months, but the authors predicted that the rapid advances being made in cardiac surgery at the time heralded a new era where hypoplastic left heart syndrome would be cured. unfortunately, that prediction remains far from true today, although dramatic advances have been made in the therapy of this otherwise lethal condition.