The diagnosis and successful management of congenital heart disease represents one of the greatest triumphs of cardiovascular medicine and surgery in the 20th century. As a consequence, the number of adults with congenital heart disease – both with repaired and unrepaired lesions – has grown rapidly, and is now approaching one million in North America. Similar increases have occurred in Western Europe. The care of adults with congenital heart disease represents a major challenge. They include a large number of diverse anatomic malformations of varying severities at various stages of their natural history and with different degrees of anatomic repair
