Total anomalous pulmonary venous drainage into the right superior vena cava

An unusual case of total anomalous pulmonary venous drainage (TAPVD) is described with four anomalous veins draining separately into the posterolateral wall of the right superior vena cava (SVC). The defect was successfully reconstructed with a pericardial patch, sutured to the posterior wall of the right SVC, right atrium and the margins of an artificially enlarged inter-atrial communication, thereby directing the pulmonary venous return into the left atrium. The right SVC was reconstructed with a further pericardial patch. Initially autologous pericardium was used, but due to contraction this had to be replaced at a further procedure with heterologous pericardium.