I n this issue of the Journal, Lewis et al. (1) give significant insight into outcomes and risks associated with pulmonary artery stenting in children with congenital heart disease while highlighting both the potential power of “big data” prospective registries and their significant limitations. The study is unique in our field as it analyzes the largest series of pulmonary artery stent procedures (>1,100) within a recent 3-year period. To put this in a historical context, the first large multicenter study of pulmonary artery stenting was published in Circulation in 1993 by O’Laughlin et al. (2) and reported only 80 pulmonary artery stent implantations collected over a 2.5-year period from the 2 largest U.S. centers performing the procedure at that time. Even in the more recent past, 3 major U.S. centers collecting retrospective data over 5 years ending in June 2011 (3) reported only 60 pulmonary artery stent implantations. A system that can collect>1,100 stent implantations in 3 years shows that we have come a long way, both in the use of pulmonary artery stents in congenital heart disease and in our ability to rapidly acquire prospective data.