Unusual case of left partial anomalous pulmonary venous connection with successful surgical management

We describe a case of left-sided partial anomalous pulmonary venous connection diagnosed in the setting of a respiratory illness affecting the right lung, which presumably elevated pulmonary pressures and worsened right-to-left shunting. The anatomical configuration appears to be highly unusual in this case, with separate supracardiac connections of the left upper pulmonary vein (LUPV) to a vertical vein (draining to the innominate vein) and the left lower pulmonary vein to the azygos vein. Successful surgical repair was undertaken with direct anastomosis of the LUPV to the left atrial appendage and creation of an intra-superior vena cava baffle to redirect azygos vein flow to the left atrium.