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The child had unique positional abnormality (where the heart lies on the opposite side), Dextrocardia. The child overall had highly complex conglomeration of heart defects, Situs solitus, Dextrocardia, Congenitally corrected transposition of great arteries, Large Sub pulmonary ventricular septal defect, severe pulmonary stenosis with complex coronary artery anatomy. The child was having progressive increase in the shortness of breath and cyanosis- intense blueness – and would not have survived beyond 20 years of age with risk of loss of life every year. By taking tougher route to treat the child, we have given the child a new heart that would last for pretty long time as the pump that is designed to pump the pink blood to the whole body has been reassigned with this highly complex undertaking. With the combining of complex intra-ventricular tunnelling, atrial switch and right ventricular to Pulmonary artery conduit, the child has been given a new lease of life. The easier approach of doing Fontan surgery is simple to execute and remains an inferior option as the long term results are disappointing and many of them do not survive beyond 40 years.