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To the Editor: We read with a great interest the article by MEI Ju and colleagues1 having obtained outstanding early and mid-term clinical outcomes of type C pulmonary atresia with ventricular septal defect (PA-VSD) and major aortopulmonary collateral arteries (MAPCAs).This is a very interesting paper,proposing a new two-stage surgery technique on treating PA-VSD with MAPCAs.However, we had some questions about it.