Children with congenital heart disease can be especially sensitive to variations in intrathoracic pressure and their subsequent impact on cardiac preload, afterload, and output. Negative-pressure ventilation, with an intrinsic ability to maintain lung recruitment while simultaneously augmenting pressure gradients favoring venous return into the thorax, can be a valuable asset in this context. Patients recovering from a bidirectional cavopulmonary (Glenn) or Fontan anastomosis may especially benefit from these cardiopulmonary interactions, as studies demonstrate improvements in cardiac index, pulmonary vascular resistance, and pulmonary blood flow with NPV use. Select physiologies might even be “rescued” from further operative interventions with this technology.