In a recent issue of your journal we read the interesting report on an infant with “Double-outlet left ventricle with l-malposition of the great arteries and subpulmonary ventricular septal defect” [6].

The authors suggested that “this anatomic variation has not been described to date in patients with a double outlet left ventricle”, this may be indeed a rare finding, however, it has been reported in the literature in at least three occasions in children with double outlet left ventricle [2–4].

In subjects with double outlet left ventricle the l-position of the aorta (i.e. the aorta anterior and left sided) is a well known anatomic pattern in which the ventricular septal defect is usually in subaortic position [1, 5]. However in some rare cases of double outlet left ventricle, the l-position of the aorta can be associated with a subpulmonary ventricular septal defect as clearly showed by two-dimensional echocardiography in the present paper [6] and in the previous reports since 1992 [2, 3].