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Transposition of the great arteries (TGA) is caused by discordance between the great arteries and the ventricles. If left untreated, this anomaly has a disastrous perspective. More recent surgical approach for correction includes the Lecompte technique in which the pulmonary bifurcation is transposed anterior to the aorta, which may be less physiologic. Although the early results are excellent, there is potential for future problems involving the great arteries and semilunar valves  1  . These potential problems necessitate the development of other improved surgical techniques  2  . Here we report an MRI 4D flow study related to a case of simple TGA whose primary surgical correction – direct spiral arterial switch operation (DSASO) – was performed twenty years ago in an attempt to restore physiologic arrangement among the great arteries and semilunar valves.

4D flow streamline characteristics of the great arteries twenty years after Lecompte and direct spiral arterial switch operation (DSASO) in simple TGA