Dr. John Myers and Dr. Brian Clark of the Penn State Children’s Hospital returned to Guayaquil, Ecuador and the Hospital de Nino’s in November to conduct back to back pediatric cardiology missions. The first week was spent performing evaluations and catheter procedures and the second week was to perform any surgeries needed. They evaluated 144 children and performed over 200 echocardiograms. Twenty eight children, varying in ages from 1 month of age to age 16, received open heart surgery. The total number of children that were managed during this mission was 229. One of the goals of this mission has always been to continue to teach and train and once again the volunteers absorbed a vast amount of knowledge in a short amount of time. Some of the latest procedures and techniques for treating pediatric heart disease and in post operative care were presented. A truly successful mission and one we hope to continue