As long-term results of arterial switch are being reported, newer sets of potential surgical problems are becoming evident. Progressive neo-aortic dilation (pulmonary valve at birth) has been observed. However, this dilation does not necessarily translate into aortic regurgitation (AR) and need for surgery in all patients. Older age at time of ASO, presence of ventricular septal defect, and previous PA banding have been found to be risk factors for AR. supravalvular pulmonary stenosis was commonly observed in the postoperative period. A direct connection of the pulmonary artery reduced the incidence of this complication