Preoperative aortopulmonary mismatch is considered a risk factor for the development of aortic insufficiency after surgery for transposition of the great arteries. We have approached these children using a neoaortic root reduction plasty. Five children with severe PA-AO discrepancy (median age 57 days) underwent arterial switch operation (ASO) associated with a V-shape neoaortic reduction plasty. At follow-up aortic regurgitation remains stable in all patients and no supra-aortic obstruction and/or neoaortic root dilatation were observed.
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