This week we explore a provocative paper on the use of a femoral vein homograft for Sano shunt for Stage I palliation for HLHS. Does the incorporation of this form of shunt improve outcomes? How does the valve in this graft function over time? Are there demonstrable improvements in RV function or PA growth when using this approach? We speak with Dr. TK Susheel Kumar who is Associate Professor of Surgery at NYU Medical Center. Dr. Kumar shares his thoughts and insights into this novel approach. https://doi.org/10.1016/j.jtcvs.2019.03.123