Congenitally corrected transposition of the great arteries may stay asymptomatic and undetected. Most ccTGAs have associated lesions like a ventricular septal defect or pulmonary stenosis, which causes symptoms and complications. Another common problem are arrhythmias and varying degrees of heart block, due to conduction anomalies. Anaesthetic management needs to be adjusted to the individual lesion, dealing with a L → R shunt or a mixing lesion. In the late stages heart failure is common and arrhythmias can occur at any time.