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Dear Dr Vincent,
Thank you very much for your kind comments 1 on our paper.
We are fully aware that many excellent catheter programmes for CHD are currently being carried out in a work environment different from that envisioned in our paper.Reference Krasemann, Berger, Liuba and Thomson 2 It is good to know that such good quality of work can be delivered even in suboptimum circumstances. But thriving for the best care of our vulnerable patients we wanted to summarise the current knowledge over the optimum-knowing that it may not be possible to achieve this everywhere, in given local circumstances. However, as you rightly pointed out, we have to plan for the future, and we hope that our manuscripts help to set up future cathlabs (or refurbishment of current cathlabs) at the best possible level.