Successful anatomical repair in congenitally corrected transposition of the great arteries depends on adequate re-routing of the atrial venous pathways. Abnormal positioning of the heart or abnormal venous drainage, or both, can impair access to the atrial pathways and previous palliative procedures can further complicate the reconstruction required to achieve anatomical repair. We describe 2 patients in whom the systemic venous anatomy was such that atrial switch was more easily accomplished by extracardiac re-routing than with the conventional Senning procedure.
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