The introduction and diffusion of cross-sectional echocardiography at the end of 1970s significantly improved case ascertainment and allowed the identification of congenital heart defects with a significant increase of mild forms. However, the prevalence of severe congenital heart disease (CHD), which represented 11.7% of overall cardiovascular malformations, remained quite stable (less than 1 per 1000 live births). In past decades, a new population of adults with CHD emerged who need specialized care in centres with trained and experienced professional staff with a different level of expertise. Clinical implications of this new scenario are discussed in this article.
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