Congenitally corrected transposition in adults with left atrioventricular valve incompetence.

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Abstract
Congenitally corrected transposition of the great vessels (CCT) is usually detected in childhood owing to the presence of associated cardiac malformations. If such malformations are absent, the patient may remain asymptomatic until adulthood; such persons usually present with left atrioventricular valve incompetence and conduction disturbances. The chest radiograph may be the 1st clue to the diagnosis, demonstrating the typical cardiovascular silhouette produced by the convex left ascending aorta. Seven cases of CCT manifested in adulthood were examined. In 4, the diagnosis was not apparent from the plain image because the ascending aorta instead followed a concave course. Hallmarks of this phenomenon are discussed and 2 radiological signs are presented: the double mediastinal stripe and the straight left lower cardiac border.