[Surgery for congenital heart disease in the adult: characteristics]

Surgery for congenital cardiopathy in adulthood presents at least four distinctive characteristics: rarity (less than 1% of all cardiac surgical procedures), extreme diversity of anatomo-clinical situations, the customary multivisceral disorder (pulmonary in particular) and certain specific technical differences (concerning the conduction of extracorporeal circulation and the surgical procedure itself). Because of these features, the operative indications are difficult to define in this population. They must be decided case by case, arriving at a well-tuned equilibrium between exaggerated intervention and excessive expectancy. Such an objective has the most chance of being realised in a specialised medico-surgical team.