Part 1 of this article (Aust NZ J Med 1993; 23: 498-503) discussed the concept of a new medical group of young adults with repaired congenital heart defects. Medical and life issues for these individuals include career prospects, insurability, pregnancy and contraception, genetic counselling, appropriate exercise, risks of non-cardiac surgery, and the need for infective endocarditis prophylaxis. Most adults with congenital heart disease lead remarkably normal lives but need intermittent medical follow-up, some as inpatients. Medical management guidelines are discussed in Part II of this review by highlighting important individual lesions.