Aiding the formation of cardiac surgical centers in developing countries includes remote training of personnel, medical team visits, and donation of equipment and supplies. When a program fails to progress, the donating organization often decides that its efforts could be more useful elsewhere. We have instead placed a US-trained pediatric heart surgeon in such a situation in order to be a catalyst and a mentor for the growth of the program. Methods: Following a “scout” trip with a small medical team, one surgeon relocated with the intention of starting an open heart surgery program in a country that had failed to develop one despite ten years of team visits. Results of the first year of this experience (Group IIa) are compared with a concurrent series of patients operated by the pre-existing local team (Group I), and with the second year’s experience (Group 1Ib). Results: Fifty-six patients were operated in Group IIa with 6 deaths (11%), five in infants undergoing palliative operations. There was one complication: a pleural effusion requiring thoracentesis. In Group I, 40 patients were operated with a mortality of 15% (p<0.02). Complications included four (10%) nontherapeutic operations (two died), one paraplegia after coarctation repair, and one reexploration for hemorrhage. Mortality in Group IIb was further decreased at 1.7% (p<0.02). Conclusions: Placement of a “mentoring” surgeon can effectively promote the safe growth of pediatric cardiac surgery in a developing country, and rapid improvement in results can be obtained. Infants undergoing palliative procedures remain high-risk surgical candidates.