Case presentation:
A 2-year-old girl was presented to our hospital when her parents noticed that she had suffered from moderate tachypnea recently. Physical examination revealed a 3/6 systolic murmur on the left sternal border and there was not any cyanosis. TTE showed an ASD of coronary sinus type of about 1.5 cm with dilated right heart cavities. The patient was scheduled for surgical closure of the ASD. Upon anaesthesia, oxygen saturation (SaO2) was 100%, and the operation was performed through median sternotomy. The pericardium was opened, and PLSVC was noticed. Complete cardiopulmonary bypass (CPB) was prepared without cannulating the PLSVC. The heart was arrested by antegrade cold blood cardioplegic solution. The right atrium (RA) was opened with an incision parallel to the right atrioventricular groove as usual. On inspection, we found that the PLSVC was draining into the roof of the LA, and a venous cannula was directed through the ASD towards its orifice to drain it (Figure 1). The pulmonary veins drainage and the mitral valve were inspected. A fresh autologous pericardial patch was used to construct a tunnel that drains the PLSVC into RA (Figure 2). The ASD was closed by another fresh autologous pericardial patch and thus the PLSVC will drain into RA (Figure 3). The remainder of the operation was completed uneventfully.