Correspondence address: Ulisses Alexandre Croti Hospital de Base – Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP) – Avenida Brigadeiro Faria Lima, 5544 – Sao Jose do Rio Preto – SP – Brazil – CEP 15090-000. E-mail: uacroti@uol.com.br Article received on May 4th, 2009 Article accepted on June 3rd, 2009 CHARACTERIZATION OF THE PATIENT 3-month and 27-day-old male child, 4.4 kg, born in Rosana, SP. Preterm birth at 36 weeks, 2.6 kg, had cyanosis on the first day of life, requiring care of neonatal intensive care for six days. The patient developed whimpering, tachydyspnea and difficult in sucking. Outpatient echocardiography at 15 days of life was requested, but due to lack of skilled professionals and the difficulty of vacancies by the Unified Health System, it was only performed after 2 months [1]. With the significant worsening of the signs of congestive heart failure, the child was emergently referred to the Hospital de Base of Sao Jose do Rio Preto. The preoperative echocardiogram in our Service revealed supracardiac type total anomalous connection of pulmonary veins, with the pulmonary veins converging into a common vein (collector sac) located posteriorly to the left atrium (LA), which drained into a vertical vein that flew into the innominate vein. Such vein, in its turn, flew into the superior vena cava (SVC). Doppler revealed a pervious foramen ovale with flow from right to left without restriction, severe pulmonary hypertension with right ventricular systolic pressure of 67 mmHg, in addition to systolic turbulent flow in right atrium (RA) compatible with functional tricuspid insufficiency. Surgical correction consisted basically of anastomosis between the hypoplastic LA and the collector sac, vertical section of the vein, resection of the oval fossa and closure of interatrial communication (IAC) with a bovine pericardium patch [2,3]. The time of cardiopulmonary bypass (CPB) was 129 minutes, myocardial ischemia 54 minutes and the total circulatory arrest was of 31 minutes at 20oC.