When to Opt for Univentricular versus Biventricular Repair in Complex Congenitally Corrected Transposition of the Great Arteries.

The surgical management of complex congenitally corrected transposition of the great arteries (ccTGA) remains a subject of ongoing debate due to wide anatomic variability and limited comparative outcomes data. Available strategies include the anatomic repair, physiologic repair, 1.5-ventricular repair, and biventricular repair, each selected based on anatomic severity and the presence of associated lesions. This commentary reviews the existing literature to inform decision-marking between univentricular, 1.5-ventricular, and biventricular repair strategies in complex ccTGA and underscores the need for further comparative studies to guide management.