“…The symptoms of this complication generally appear soon after surgery when the patient becomes cyanotic and hypoxic; however, some factors such as the relief of pulmonary venous congestion and right ventricular strain by the correction of the left-to-right shunt, the occurrence of only partial diversion of the IVC flow to the LA, and the occurrence of stenosis of the IVC, with collaterals draining to the SVC through an azygos vein may contribute to the appearance of the symptoms of this complication later in life (3) . Reported factors associated with this complication include a large secundum defect or sinus venosus defect, and anomalous pulmonary return into the RA (4) . Cannulation of the IVC and SVC through the auricle of the right atrium may play a role in increasing the risk of diversion of the IVC into the LA, especially in IVC type ASD.…”