The current era of cardiology has seen a significant increase in the number of adults living with congenital heart disease (CHD). Although advances in medical and surgical management have resulted in approximately 90 % of children with CHD living into adulthood, many suffer from late complications, with myocardial dysfunction as the leading cause of morbidity and mortality. The heterogeneity of the adult congenital heart disease (ACHD) population has presented a challenge, as there are only limited data regarding appropriate treatment modalities. Given the growing ACHD population and the high morbidity and mortality related to myocardial dysfunction, a comprehensive approach to heart failure (HF) care is recommended in conjunction with ACHD and HF specialty care. The field must focus on developing research strategies to leverage existing and future medical and surgical treatment options in order to improve outcomes in this diverse population.