ABC | Volume 115, Nº1, Suplement, July 2020

Clinicoradiological Correlation Arq Bras Cardiol 2020; 115(1Suppl.1):34-36 Atik et al. Corrected transposition of the great arteries, with good natural evolution until 65 years 1. Agarwal A,  Samad F , Kalvin L, Bush M, Tajik AJ. A great imitator in adult cardiology practice: congenitallycorrected transposition of thegreat arteries. Congenit Heart Dis. 2017;12(2):143-52. 2. Placci A, Lovato L, Bonvicini M. Congenitally corrected  transposition of the great arteries in an 83-year-old asymptomatic patient: description and literature review. BMJ Case Rep. 2014 Oct 21;2014:cr2014204228. 3. Shahab H, Ashiqali S, Atiq M Congenitally Corrected Transposition of the Great Arteries in a Septuagenarian from the Developing Country of Pakistan. Cureus. 2018;10(6):e2737. 4. Connolly HM, MirandaWR, Egbe AC, Warnes CA. Management of the Adult PatientWithCongenitallyCorrectedTransposition:ChallengesandUncertainties. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2019;22:61-5. References This is an open-access article distributed under the terms of the Creative Commons Attribution License externalized with associated defects in relation to their absence. It simulates Tetralogy of Fallot when it is associated with interventricular septal defect and pulmonary stenosis, VSD in the presence of the same associated defect and mitral valve regurgitation in the presence of left atrioventricular valve regurgitation. When CTGA shows no associated defects (15% of cases), the natural evolution is characterized by the evolution of the atrioventricular conduction disorder, altered by the very long right bundle, which favors the appearance of total atrioventricular block. Moreover, due to the emergence of the right ventricular insufficiency, which, due to hypertrophy and dilation, leads to relative coronary insufficiency with fibrosis and consequent ventricular dysfunction. However, rare cases have a more favorable evolution, as in the case discussed here. In the literature, some of these cases have also shown such a favorable evolution, citing eight of them recently described with little clinical manifestation 1 .In addition to these, the oldest one was described at 83 years old and asymptomatic 2 and yet another patient at 70 years old, asymptomatic and with associated pulmonary valve stenosis, with a protective gradient of 49.9 mmHg between the left ventricle and the pulmonary trunk 3 . The management of these patients depends on the presence of symptoms, the degree of ventricular dysfunction and the complications related to the natural evolution of the congenital defect 4 . 36