Waiting lists for cardiac surgery, although unavoidable, can have adverse effects on the patients concerned through increased risk of death and other ischaemic related events, as well as loss in quality of life.1 The extent to which delayed surgery affects patient outcome varies widely between patients, being dependent on factors such as disease severity, symptom experience, and waiting time. Therefore, it is important to manage waiting lists sensibly in a manner that aims to be equitable, reduce overall risk, and maintain or improve quality of life as much as possible. Two papers in this issue address different aspects of the waiting list problem.2 ,3