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Figure 3 (A) Chest radiograph of a 16-year-old young man with congenitally corrected transposition just after implantation of an endocardial pacemaker. Reportedly, his systemic ventricular ejection fraction was 40%, and he had moderate systemic atrioventricular valve (the tricuspid valve) regurgitation. (B) Chest radiograph 18 months later at the time of referral. His systemic ventricular ejection fraction was 15%, and he had severe systemic atrioventricular valve regurgitation. Cardiac transplantation was the only viable surgical option, because the referral was too late for conventional operation.
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