 congenit heart diseas adult event natur cours 310 adult patient prove congenit cardiac anomali review determin incid longev complic death atrial septal defect patent ductu arteriosu frequent encount lesion compris third entir seri ventricular septal defect pulmon stenosi quarter group twenti-two instanc eisenmeng syndrom secondari varieti shunt lesion includ bacteri endocard sudden death cardiac decompens greatest threat patient symptom minim appear heart failur common death older patient sudden death occur patient ventricular septal defect clinic featur characterist congenit malform young adult acyanot congenit heart diseas misdiagnos rheumat older patient present manifest frequent attribut arteriosclerot heart diseas time associ acquir cardiovascular disord alter basic syndrom three quarter patient surviv continu observ abil live activ product live withstand stress surgeri cardiac non-cardiac pregnanc impress observ patient congenit heart diseas surgic intervent essenti accur evalu long term efficaci cardiac surgeri 