PEDIATRICS: Edited by James C. HuhtaAdvances in neonatal cardiac surgery recent advances, the low-hanging fruit, what is on the horizon and the next moonshotTweddell, James S.Author Information Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA Correspondence to James S. Tweddell, MD, Director of Surgery and Executive Co-Director of the Heart Institute, Cincinnati Children's Hospital Medical Center, Professor of Surgery, University of Cincinnati, 3333 Burnet Ave., MLC 2013, Cincinnati OH, 45229, US. A. Tel: +1 513 803 8824; e-mail: James.Tweddell@CCHMC.org Current Opinion in Cardiology: January 2016 - Volume 31 - Issue 1 - p 109-116 doi: 10.1097/HCO.0000000000000244 Buy Metrics Abstract Purpose of review To review the recent advances in neonatal cardiac surgery and identify future directions of this subspecialty of congenital heart surgery. Recent findings Recent advances in neonatal cardiac surgery have included the right ventricular to pulmonary artery conduit, the hybrid procedure and antegrade cerebral perfusion. In addition to refining the indications and techniques for these strategies, we can advance the field through collaborative learning between neonatal heart surgery centers. Collaborative learning is the low-hanging fruit that we can all use to advance the care of this patient population. On the horizon are a variety of strategies that will improve our management of this complex patient population. Among these improvements are better anticoagulation strategies targeting the unique hemostatic system of the neonate. The next transformative change, the next moonshot, may well be regenerative therapy that unlocks the body's ability to regenerate specific tissue such as valves and heart muscle to correct congenital defects and repair damaged muscle. Summary The current state of the specialty of neonatal cardiac surgery will be reviewed, and the possible future directions based on their ease and likelihood: specifically, the low-hanging fruit, what is on the horizon and the next moonshot. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.