Repair of postoperative ductal aneurysm through left thoracotomy is difficult due to extreme fragility of aneurysm and because of reoperative difficulties. The immediate and long-term outcome of the cases operated through sternotomy using total circulatory arrest with minimal dissection is good. Midline sternotomy limits approach to descending thoracic aorta that can be circumvented by using transverse sternotomy with semi-right-lateral positioning of the patient.

A 9-year-old girl with cyanosis, dyspnea, and grade II clubbing was diagnosed by contrast transthoracic echocardiography and angiocardiography to have an anomalous connection of the venae cavae to the physiologic left atrium with partial anomalous pulmonary venous connection. Successful surgical correction was achieved, and the patient's recovery was uneventful.