Transposition of the great arteries with posterior aorta. Anatomic repair.

An uncommon but historically important form of transposition of the great arteries (S,D,D) was originally recognized in 1971. The unusual features of an aorta that is posterior and to the right of the pulmonary artery, a hypoplastic subaortic conus, and a well-developed subpulmonary conus influenced the evolution of the contemporary classification of conotruncal abnormalities and concepts of their development. Presented in this report is the case of a patient with transposition of the great arteries (S,D,D) and posterior aorta treated by an arterial switch operation. The unusual orientation of the great arteries did not preclude coronary transplantation or a satisfactory pulmonary arterial anastomosis. Moreover, the ventricular septal defect, which is characteristic of this atypical form of transposition of the great arteries, was most accessible for closure through the native aortic valve.