A 37-year-old woman was referred to our institution for minimally invasive surgical repair of a partial anomalous pulmonary venous connection of the right upper pulmonary vein into the superior vena cava and a sinus venosus atrial septal defect. Diagnosis was refined on admission. The patient received routine preparation in the operating room by oral intubation, right radial arterial line, and a left jugular central venous pressure catheter. Peripheral superior vena cava cannulation (Medtronic Inc., Minneapolis, Minn) was used to reduce the length of the thoracotomy. Through a right posterolateral thoracotomy, cardiopulmonary bypass was performed, and the aorta was cross-clamped. On cardiopulmonary bypass, during surgical repair of the anomalous pulmonary venous drainage by baffling it into the left atrium with an autologous pericardial patch, hemodynamic instability and hypovolemia occurred, requiring plasma expanders and packed red blood cell transfusion.
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