This week we discuss the rationale for intervening for unilateral proximal PA stenosis with a stent or angioplasty. In the setting of normal RV function or pressure, are there exercise data to support intervening and if so, at what degree of maldistribution should such an intervention be considered? How should this decision be made? Is this safe? We review these and other questions with the first author of this work, Gurumurthy Hiremath MD who is the director of the pediatric catheterization laboratory at the University of Minnesota. doi: 10.1016/j.jcin.2018.11.042