Patients born with structural heart disease, or those diagnosed early in life with an acquired condition, may never have developed exercise skills or worked on cardiovascular conditioning. Unlike older patients who need cardiac rehabilitation to return to a former state of health after an event or intervention, these young patients need to reach a new level of health via structured exercise training to optimize their cardiopulmonary capabilities. Despite the differences, both populations benefit from Cardiac Rehab and Secondary Prevention Programs to improve their functional capacity, gain habits for long term heart healthy living, and enhance their quality of life. We will present patient clinical findings and outcomes from the Cardiac Rehabilitation Registries from both Cincinnati Children’s Hospital and Boston Children’s Hospital, including performance data on patients with congenital heart disease, pediatric acquired heart disease, and those who have had a heart transplant. There will be an interactive question and answer period after the presentations. Session topics will include: 1. The newly developed cardiac rehabilitation curriculum designed for congenital heart disease patients, which encompass risk stratification, exercise progression, education, and assessment. 2. Approaches to effectively deliver a hybrid model via technology. 3. The psychosocial issues that are unique to this patient population and the strategies used to address this in a cardiac rehabilitation program.