Developed in Collaboration With the American Association for Tho- racic Surgery, American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angi- ography and Interventions, and Society of Thoracic Surgeons ACC/AHA Task Force Members, see page e772 The American Heart Association requests that this document be cited as follows: Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, Crumb SR, Dearani JA, Fuller S, Gurvitz M, Khairy P, Landzberg MJ, Saidi A, Valente AM, Van Hare GF. 2018 AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Key Words: AHA Scientific Statements arrhythmias cardiac catheterization cardiac defects congenital heart disease congenital heart surgery unoperated/repaired heart defect CLINICAL STATEMENTS AND GUIDELINES TABLE OF CONTENTS Preamble e700 1. Introduction e701 1.1. Methodology and Evidence Review e701 1.2. Organization of the Writing Committee e702 1.3. Document Review and Approval e703 1.4. Scope of the Guideline e703 1.5. Abbreviations e705 2. Background and Pathophysiology e705 2.1. Anatomic and Physiological Terms e705 2.2. Severity of ACHD e705 2.3. The ACHD Anatomic and Physiological Classification e705 3. General Principles e709 3.1. ACHD Program e709 3.2. Access to Care e709 3.3. Delivery of Care e710 3.4. Evaluation of Suspected and Known CHD e710 3.4.1. Electrocardiogram e713 3.4.2. Ionizing Radiation Principles e713 3.4.3. Echocardiography e713 3.4.4. CMR Imaging e714 3.4.5. Cardiac Computed Tomography e714 3.4.6. Cardiac Catheterization e715 3.4.7. Exercise Testing e715 3.5. Transition Education e716 3.6. Exercise and Sports e716 3.7. Mental Health and Neurodevelopmental Issues e717 3.8. Endocarditis Prevention e717 3.9. Concomitant Syndromes e717 3.10. Acquired Cardiovascular Disease e718 3.11. Noncardiac Medical Issues e719 3.12. Noncardiac Surgery e719 3.13. Pregnancy, Reproduction, and Sexual Health e720 3.13.1. 