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The natural history of ccTGA is also greatly influenced by the nature and severity of accompanying lesions, some of which require surgical repair. Some management strategies leave the right ventricle as the systemic arterial pump, but carry the risk of worsening heart failure. More complex \u2018double switch\u2019 repairs establish the left ventricle as the systemic pump, and include an atrial baffle to redirect venous return in combination with either arterial switch or Rastelli operation (if a suitable ventricular septal defect permits). Occasionally, the anatomic peculiarities of ccTGA do not allow straightforward biventricular repair, and Fontan palliation is a reasonable option. Regardless of the approach selected, late cardiovascular complications are relatively common, so ongoing outpatient surveillance should be established in an age-appropriate facility with expertise in congenital heart disease care.<\/jats:p>","DOI":"10.1136\/heartjnl-2016-311032","type":"journal-article","created":{"date-parts":[[2018,1,11]],"date-time":"2018-01-11T12:21:56Z","timestamp":1515673316000},"page":"1148-1155","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":71,"title":["Contemporary management and outcomes in congenitally corrected transposition of the great arteries"],"prefix":"10.1136","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9428-0979","authenticated-orcid":false,"given":"Shelby","family":"Kutty","sequence":"first","affiliation":[{"name":"Division of Cardiology, University of Nebraska College of Medicine and Children\u2019s Hospital and Medical Center, Omaha, Nebraska, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Danford","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Nebraska College of Medicine and Children\u2019s Hospital and Medical Center, Omaha, Nebraska, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard-Paul","family":"Diller","sequence":"additional","affiliation":[{"name":"Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oktay","family":"Tutarel","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology and Congenital Heart Disease, German Heart Centre Munich, Technical University of Munich, Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,1,11]]},"reference":[{"key":"2025092012404191000_104.14.1148.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.627224"},{"key":"2025092012404191000_104.14.1148.2","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1056\/NEJM197005072821901","article-title":"Clinical profile of patients with congenital corrected transposition of the great arteries. 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