1. Orientation: Situs inversus totalis; dextrocardia; Infero-posterior morphologic LV,
supero-anterior morphologic RV; Right aortic arch with mirror-image branching
2. Segmental anatomy: Complex TGA: Concordant A-V, discordant V-A connections: posterior pulmonary valve,
anterior aortic valve, with ventricular L-loop
3. Shunts: Secondum ASD; Membranous VSD
4. Pulmonary stenosis; subpulmonary outflow tract obstruction.
1. Patch closure of membranous VSD, tunnel-like connection of LV to aorta; pulmonary valvotomy and excision of fibrous tissue from the RVOT,
closure of secundum ASD;
2. Removal of VSD patch, Morrow-like incision on the ventricular septum; closure of VSD,
Relief of subpulmonic outflow obstruction; transvenous atrial and ventricular pacemaker insertion