Advances in the diagnosis and treatment of heart disease have significantly affected survival patterns. Many adults with these anomalies have never had cardiac surgery because they have not required operation, their lesions are treatable in adulthood, or they are inoperable. A large number have reached adult life after undergoing cardiovascular surgery in infancy and childhood. Generally, results in these patients are gratifying, but cure is seldom achieved, and many have important sequelae and residua.