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Cohort studyWe compared the overall rate of detection of duct dependent circulation in West Gtaland with that in other regions not using pulse oximetry screening but which also refer children to the same supra regional centre for congenital cardiac surgery (Queen Silvia Children’s Hospital, Gothenburg). We retrieved data from the surgical and catheter procedure records, logbooks of children turned down for surgery, and deaths in the community (see below). All referring hospitals were asked to give details of infants who had died before being referred or declined referral during the study period. We examined the medical records of all babies with duct dependent circulation in the two cohort populations and recorded preoperative acidosis and 30 day mortality.