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A 55-year-old man presented with recent-onset oedema of lower extremity. He had cyanosis and clubbing since childhood, but his exercise tolerance was relatively good. Transthoracic echocardiography (TTE) demonstrated significantly dilated and hypertrophied right ventricle, moderate pulmonary stenosis and an atrial septal defect (ASD) of 27 mm with right-to-left shunt ( Panels A–C and Supplementary data online, Video S1 ). Peak pressure …

Rare variant of mixed total anomalous pulmonary venous drainage (TAPVD) in a 55-year-old patient