Complete transposition of the great arteries is a common life-threatening complex cyanotic congenital heart disease in infants, resulting in the operation usually performed about one week after birth. However, little is known about the surgical strategy and experience of transposition of the great arteries with an intact ventricular septum in older patients. Herein, we present an abandoned 7-year-old boy with severe cyanosis with clubbed fingers and toes and then diagnosed with transposition of the great arteries with an intact ventricular septum, atrial septal defect, patent ductus arteriosus, and pulmonary hypertension. The patient underwent a two-staged procedure: an aortopulmonary shunt and pulmonary artery banding were performed at the first stage, followed by the Switch operation, defect repair, and patent ductus arteriosus ligation, all of which were successfully performed. The patient was discharged on the 15th day after the operation, and the arterial oxygen saturation returned to normal level (99%). The illustrative report highlights the essence of raising awareness and developing accurate treatment strategy of transposition of the great arteries, especially in remote rural areas of eastern countries, where the level of health care and services is relatively underdeveloped.

Arterial switch surgery for d-transposition of great arteries is usually performed in the first 2 weeks of life before the left ventricle regresses. The arterial switch surgery that helps achieve anatomic and physiologic correction of this condition has better long-term outcomes than other surgical approaches. The procedure may still be attempted at an older age where the left ventricle has not regressed. We report a rare case of a 12-year-old child with d-transposition of great arteries, a remote muscular ventricular septal defect and isolated valvar pulmonic stenosis, which was corrected by an arterial switch surgery.