Balanced chaos: A 55-year journey with unrepaired D-transposition of great arteries, ventricular septal defect, subvalvular and valvular pulmonary stenosis

We report a rare case of unoperated D-transposition of the great arteries (d-TGA) in a 55-year-old homeless patient presenting with exertional dyspnea and cyanosis. Echocardiographic findings revealed d-TGA with an outlet ventricular septal defect and concurrent subvalvular and valvular pulmonary stenosis. Due to delayed age of diagnosis, limited data on adult d-TGA outcomes, and socioeconomic factors, surgical intervention was not pursued. Instead, palliative care measures were implemented, underscoring the importance of early diagnosis, tailored care plans, and comprehensive support structures to optimize outcomes.