How to improve natural history of adults with congenital heart disease?

Improving the natural history of adults with CHD: As mentioned above the populations of adults with CHD are largely constituted by conditions with a relatively favourable natural history that allow survival until adulthood. There is, however, considerable attrition during adult life and many of these conditions can benefit from intervention (surgery or trans-catheter intervention) even during adulthood. The decision regarding he need for intervention and timing of intervention needs to be individualized because of the enormous variety of conditions encountered in adulthood. The indications for surgery or transcatheter interventions for the individual conditions