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Modern cardiology is both a complex business and a team sport. Treatment options have expanded and now extend to patients whose age and degree of sickness might have excluded them in the past. Correct diagnosis and treatment can be challenging, and imaging is central to understanding cardiac pathology and to guiding optimal treatment choices. It is almost impossible for a single physician to have full mastery of all the imaging tools available for diagnosis. Instead, it is incumbent upon hospitals to establish imaging teams which have both overlapping and unique expertise. These may be drawn from the ranks of cardiology, radiology, or nuclear medicine—skill set is of more importance than background specialty. Heart imaging teams, working together in unison, represent an ideal model to facilitate the right test at the right time for the right patient.

There are now more adults alive with congenital heart disease than children (Marelli et al. 2007), and many will have ongoing problems despite surgical repair. Surgery is never a cure—merely a fix—and in some cases directly introduces new problems that were not present previously (Celermajer and Greaves 2002). ACHD patients therefore generally require lifelong follow-up in specialized institutions where the technical and clinical expertise exists to recognize and deal with issues as they arise.

Anomalies of the coronary arteries are paradoxically amongst the simplest and most difficult of subjects to get to grips with in congenital heart disease. This chapter reviews some of the commoner congenital anomalies encountered and discusses technical tips and tricks for optimal CMR imaging.

Tricuspid valve abnormalities are relatively rare lesions in the spectrum of congenital heart disease which can affect the leaflets, chordal apparatus, and/or papillary muscles of the tricuspid valve. Ebstein anomaly is the most common form of congenital tricuspid valve disease. Although outcomes remain poor in neonates with important tricuspid valve disease, Ebstein anomaly can be managed successfully in children, adolescents, and young adults with recent surgical advances and current interventional techniques. Comprehensive cardiac imaging is essential to allow for accurate diagnosis and appropriate decision-making, and should always be performed by an advanced cardiac imaging specialist with expertise in congenital heart disease. In this chapter, anatomical features pertaining to the range of congenital heart defects which affect the tricuspid valve are reviewed, current imaging techniques are detailed, and contemporary approaches to management are discussed.