The first reference in history to the presence of congenital heart defects comes from a Babylonian tablet which dates back to around 4,000 BC. The description mentions: When a woman gives birth to an infant that has the heart open and has no skin, the country will suffer from calamities, which might refer to ectopia cordis.1 Leonardo da Vinci then was the first to describe a congenital heart defect (atrial septal defect) in humans in his Quaderni de Anatomia1 (Fig. 19.1).