Due to improving results in congenital heart surgery, the number of adult patients with
congenital heart defect is increasing. The question is: what kind of problems can be managed in this patient-group? The authors review the different problems of management of
congenital heart defects in adults based on national and international literature data. Simple defects recognised in adults, postoperative residual problems, changing of small grafts and valves, correction of primary or operated coarctation aortae can be usually managed without problems. A very close follow-up is necessary to establish the correct period for
heart transplantation in patients with
transposition of great arteries with Senning/
Mustard operation, and
univentricular heart corrected with "
Fontan-circulation" type
surgical procedure. The authors conclude that although the number of patients increases, only a few
congenital heart diseases may cause problems. It seems important (1) to monitor asymptomatic patient who underwent operation (Fallot-IV, Ross procedure, etc.), (2) follow up regularly patients who underwent Senning/
Mustard procedure (magnetic resonance imaging, echocardiography,
brain natriuretic peptide measurement), (3) define the proper period of preparation for
heart transplantation of patients with a
univentricular heart, with special attention to the possibility of multiorgan (lung, liver, etc.) failure. Due to the improvement of foetal diagnosis of
congenital heart defects, the number of patients with complex
congenital heart defects is decreasing. The standard management of these patients could be primary
heart transplantation in infancy.