As increasing numbers of patients with congenital heart disease (CHD) survive the neonatal period and reach adulthood we are faced with a growing patient population, both, in terms of numbers and complexity of disease. The vast majority of patients are not cured and requires life-long specialized medical care. The current focus issue on congenital heart disease combines publications dealing specifically with this challenging group of patients. It highlights the heterogeneity of problems faced by congenital cardiologists, spanning from a changing diagnostic spectrum to issues of risk stratification, haemodynamic assessment as well as the growing issue of pregnancy in patients with congenital heart disease.

The Editor's choice in this issue is a prospective study by Balci and colleagues (see page 1373). The authors aimed to prospectively validate three published risk models of adverse outcome during pregnancy in women with congenital heart disease. Based on a sample of 213 pregnancies in 203 women, the authors investigated prospectively, the validity of three commonly used risk scores for maternal and offspring risk. The scoring instruments included were the ZAHARA I, the CARPREG score and the WHO classification of maternal cardiovascular risk. The authors show that all three scoring systems have important limitations when predicting risk to mother and child. This is illustrated …