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Hepburn L et al. – With advances in early treatment, babies with congenital heart disease are now usually surviving to adulthood. They are, therefore, increasingly presenting as adults to non–specialist units for medical care. It should be recognized that patients with pulmonary hypertension or Eisenmenger's syndrome are at extremely high risk of death in the perioperative period, and in all but life–threatening situations they should be cared for in specialist centres.

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