The period in which cardiac surgery evolved was a period of exceptional discoveries, it developed within my lifetime. There were the pioneers, teachers of some of us, who worked with unlimited energy, clear concepts and an abundance of creative ideas to establish methods for the treatment of congenital cardiac anomalies which over time were to develop into practical concepts which have now spread all over the world.The pioneer years saw many disappointments and sleepless nights, a lot of frustration and self-reproach because of failures and errors. The only road ahead was to trust in concepts and convictions, to objectively analyse one's own experience or the published data of others; above all, it lay in personal persistence.These scientific achievements became the basis for the cardiac surgical treatment of children, infants and -nowadays -newborns, the foundation of pediatric cardiology. Today almost any congenital cardiac anomaly can be treated, even though many, operated on as children remain a continuing sorrow. Although at the moment the number of neonates and of infants with complex congenital failures is decreasing, there is still a need for congenital cardiac surgeons, perhaps -since there are indications that the concentration of manpower, knowledge, and experience leads to better results -in a reduced and controlled number of centers.The increasing understanding of the human genome and the use of molecular genetics will help us to understand the causes of congenital cardiac anomalies, thus preventing their origin -but not in the near future. The progress achieved during the past century in this particular field of surgery is incredible and worthy of a retrospective review.Surgical therapy for congenital cardiac diseases started with palliation. The first really revolutionary operation was performed on November 29, 1944 on a 15-month-old female infant with Tetralogy of Fallot (TOF) by Alfred Blalock at the Johns Hopkins Hospital in Baltimore. The idea for this life-saving shunt operation was developed by Helen Taussig -a deaf pediatrician, so the story goes -and a blind surgeon. Indeed Helen Taussig needed a special auscultation device and because of severe myopy Blalock used very strong spectacles when operating. That, at least, is the story. Actually Blalock, together with S. E. Levy and Vivien Thomas, had operated on dogs some time before, at Vanderbilt University in Tennessee, where he constructed left subclavianpulmonary shunts imitating open ducti and attempted to create pulmonary hypertension.A similar operation to improve the prognosis for cyanotic heart disease was performed by Willis John Potts in Chicago (November 1946), after he and his instrument maker Sidney Smith had constructed his famous clamp. In Europe, T. Holmes Sellors and Russell Claude Brock, in different London hospitals, initiated a transventricular approach to increase pulmonary blood flow, the first on December 4, 1947, the second in February 1948.In January 1948 Alfred Lord Blalock gave the first Rudolph Matas Lecture in New...