An infant with a simple transposition of the great arteries underwent the Jatene operation at 44 days of life. Cyanosis when crying, failure to thrive, and cardiac enlargement appeared 3 months after operation. The cardiac catheterization at that time re- vealed severe stenosis of the right pulmonary artery at its origin (PS) and massive pulmonary regurgi-tation (PR). Reoperation was performed at 8 months of life. PS was relieved by enlargement of the narrow segment with a patch. PR was caused by destruction of the right coronary cusp of the original aortic valve, where the ostium of single coronary artery was excised as a button, and the defect was made up with a piece of porcine pericardium as a patch. This abnormality was left unrepaired. The postoperative course was uneventful and the patient was discharged on the 22nd postoperative day. On pulsed doppler echocardiography PR was improved.
