Studies of pediatric cardiopulmonary disease demonstrate significant advances in medical and surgical therapy. Of special interest are studies evaluating echocardiography (fetal and neonatal) interventional cardiology, changes in surfactant associated with cardiopulmonary bypass, and alterations in cerebral perfusion during low-flow or circulatory arrest states. This review also reflects the prevailing interest in preserving myocardial perfusion and function and in improving outcome after heart transplantation.