Cardiologists assuming responsibility for adults with congenital heart disease must have knowledge of electrophysiologic, valvular (native valves), prosthetic (valves, patches and conduits), ventricular (especially chamber function), vascular (especially elevated pulmonary vascular resistance) and noncardiovascular residua and sequelae. Acquired cardiac and noncardiac diseases coexist in older adults with postoperative congenital heart disease and add to the physician's responsibilities.