Transposition of great arteries with left ventricular outflow tract obstruction undergoing definitive repair beyond the third decade.

A 30-year-old male presented with progressive dyspnea, cyanosis, and chest pain due to unrepaired d-transposition of the great arteries with ventricular septal defect (VSD) and severe left ventricular outflow tract obstruction, underwent successful late biventricular repair including VSD closure, neo-aortic mechanical valve implantation, coronary transfer, and LeCompte maneuver. Despite postoperative stroke and complete heart block requiring pacemaker implantation, he was discharged in stable condition with preserved biventricular function. This case supports the feasibility of anatomic repair beyond the third decade.