Not so long ago, congenital heart disease was primarily a paediatric condition. Due to the decrease in pediatric mortality of multifactorial origin, adult patients with congenital heart disease represent a new patient population that is constantly growing in number and complexity and requires specialized management. The surgery of these heart diseases in adulthood has particular characteristics that differentiate it from congenital heart surgery in children and from the surgery of acquired cardiac pathologies. The specific management of adults with congenital heart disease (GUCH) in reference centres has contributed to the improvement of surgical results in terms of mortality and subsequent quality of life.