Definitive, if not curative surgery is available for the eight most common congenital cardiac defects—ductus arteriosus, ASD, VSD, coarctation, pulmonary valve stenosis, aortic valve stenosis, tetralogy of Fallot, and transposition. The results of surgery for uncomplicated cases of DA, ASD, VSD, and coarctation usually can be determined by clinical means (including chest radiogram and ECG). Postoperative heart catheterization is recommended for evaluation of the patient who has had surgery for pulmonary valve stenosis or aortic stenosis and is necessary after tetralogy of Fallot or transposition of the great arteries repair to identify the important postoperative residua and sequelae. The term “curative” surgery probably should be reserved for operation for division of ductus arteriosus unassociated with pulmonary hypertension and performed in childhood. After closure of ASD, patients should continue to be observed for late development of arrhythmias and persistent cardiac enlargement, although the incidence of these problems is low. After VSD closure the patient is still followed at intervals for possible ill effects of the ventriculotomy scar, manifest as arrhythmias, ventricular aneurysm or myocardial insufficiency. The patient with coarctation repair must be observed for a possible late complication from one of the several clinically silent cardiovascular or cerebrovascular anomalies as well as for the chance of restenosis or unrelieved hypertension. Patients who have had an effective relief of the pressure gradient from pulmonary valve stenosis have a good outlook but should be observed for signs of myocardial insufficiency or the possible effects of increased load on the right heart resulting from pulmonary insufficiency. The high incidence of some degree of aortic insufficiency after valvotomy for aortic valve stenosis as well as the slight chance of restenosis necessitates follow-up examinations for these patients. After tetralogy of Fallot repair partially unrelieved infundibular stenosis or pulmonary annular stenosis and/or persistent VSD may require some limitation of physical activities even though the patient feels much improved because of disappearance of the cyanosis. Whether there are residual defects or not, patients should continue to be re-examined annually for an indefinite period of time because of possible myocardial insufficiency or arrhythmias. The problems after transposition repair include arrhythmias, right ventricular myocardial insufficiency, tricuspid insufficiency, persistent communications around the atrial baffle, and vena caval and/or pulmonary vein stenosis. Despite the frequent residua and sequelae of surgery, most patients with transposition obtain remarkable relief of symptoms. The use of exercise stress testing should increase the reliability of clinic assessment of the operative result. In those patients at risk for arrhythmias after surgery, electrophysiological studies at the time of postop cath may contribute to the management of the patient. The addition of ultrasound in the pre and postoperative evaluation of patients will aid the identification of certain clinically silent associated defects and some of the postoperative sequelae. The risk of subacute bacterial endocarditis remains in most patients after intracardiac repair of defects and, with few exceptions, patients who have had definitive surgery require long-term follow-up despite relief of symptoms and the disappearance of clinical manifestations of cardiovascular dysfunction. It is reasonable to expect that with improvement in diagnostic and surgical technique, many of the currently acceptable residua and sequelae of surgery for congenital heart disease will, in the future, be designated as avoidable complications in these patients. With the current healthy interest in long-term postoperative results there is a good chance that more precise information will become available to guide in the selection for surgery of the patient with congenital heart disease.