Persistent pulmonary artery hypertension following supracardiac total anomalous pulmonary venous connection repair

We report a case of supracardiac total anomalous pulmonary venous connection (TAPVC) with persistent post operative pulmonary hypertension unresponsive to sildenafil. Only after ligation of vertical vein, echocardiography could detect a perimembranous ventricular septal defect (VSD). Following VSD closure, pulmonary artery pressure declined and patient improved.