The end of the 1980s also brings to an end an era in which gross anatomic studies contributed in a major way to the understanding of congenital heart malformations. Indeed, a survey of the literature available for this review shows very little once studies correlating pathology with clinical aspects are left out. This review, therefore, is based on a single report on ventricular septal defects and criticizes the terminology and classification chosen. The importance of the subject and the need to achieve understanding justifies a thorough examination of this study.