Double-outlet right ventricle (DORV) is a type of ventriculoarterial connection in which both great vessels arise entirely or predominantly from the right ventricle. Many controversies associated with DORV relate to its anatomic definition, and surgical management. The complications associated with repair of these variable effects relate to the management of the ventricular septal defect (residual defects), acquired heart block, atrial and ventricular arrhythmias, aortic and pulmonary valve injury during subarterial resection, coronary artery rotational problems and myocardial ischemia associated with arterial switch, inappropriate intraventricular tunneling, and acquired subarterial stenosis. These complications will be identified, discussed, and be the focus of resolution.