Luis is a 4 year old who was born with several problems. He had a hole in his heart as well as a cleft of his lip and palate. When he was less than a year old he had his heart defect repaired in Lima. Last year he came to us to have his lip repaired. Normally, we do not do children with multiple problems as the risk of complications after surgery is higher. Last year our pediatrician was also a heart specialist and he felt there was no reason not to do the lip repair. The day of surgery, Luis had a cold so we had to cancel him. This year he came again, but I did not remember him right away and the rest of the team was concerned. After hard work by our anesthesia resident who found the local cardiologist and had the studies interpreted, we all agreed that he was not at any higher risk than any other child and today he had his surgery.