ABSTRACT
Asymmetric crying facies is due to hypoplasia or absence of the depressor anguli oris muscle . It is called Cayler cardiofacial syndrome when associated with congenital heart disease. We report the case of an infant girl with asymmetric crying facies and complex congenital heart disease that associate transposition of the great arteries, intracardiac total anomalous pulmonary venous return, coarctation of the aorta, atrial septal defect, patent ductus arteriosus, hypoplasia of the right and left pulmonary arteries and left juxtaposition of the appendenges. The infant has also other systemic anomalies: microcephaly, right auricular hypoplasia, bilateral renal hypoplasia and serious central nervous system anomalies. Asymmetric crying facies is a minor congenital anomaly that can be associated to other severe malformations