Thanks to the enormous progress in the field of cardiac surgery and paediatric cardiology since the mid of 20th
century, more and more children with congenital heart defects reach the adulthood. This on the other hand encounter physician
and patients various problems due to late complications after the heart surgery like congestive heart failure, arrhythmia
and sudden death. One of the challenging area is the medical management of heart failure in these patients with
complex anatomy and hemodynamics. The lack of evidence of the effectiveness of the anti congestive medications in this
population in from of large randomized controlled trials, makes it difficult to establish universally accepted therapy guidelines.
In this article we will review the evidence of the beta-blockers in heart failure in patients with congenital heart disease.
Also we will discuss the mechanisms of heart failure in this patient's cohort and will review the literature with respect to
the use of neurohormonal antagonists in congenital heart disease. There is an urgent need to initiate well-designed clinical
trials to prove if the positive results of neurohormonal blockade in acquired heart failure in adults can be translated in patients
with congenital heart disease.