Not much. I worked primarily on a large app written in C++ and MFC. We moved to VS 2008 before Vista (waiting for VS 2008 SP1, which saved a lot of trouble), and most things just simply worked. There was one external library I found a slight problem with (compensating for old VC++ problems), but no big deal.
Except for a routine to grab a window and put it into JPEG format, which I narrowed down to a small stretch of standard code that was vetted by competent people both here and on the MSDN forum. Eventually, that problem went away on my computer, so I couldn't pursue it, but it has cropped up on others.
So, I never know when the goblins are going to come and take the JPEGs away, but other than that the transition to Vista was smooth.