It is a rare case of transposition of the great arteries with intact interventricular septum, associated to functional aortic valve atresia. The presence of a tiny aortic regurgitation confirms the functional nature of the atresia. The right ventricle is smaller than the predicted size for the age and the malformation. There is tricuspid regurgitation that can explain poor filling and development of the right ventricle
that has not enough pressure to pump into the aorta. Systemic circulation is preserved due to the large arterial duct that irrigates in a retrograde way the ascending aorta (red flow in the aorta).