Conclusion
Tetralogy of Fallot is rarely associated with anomalous pulmonary venous return. Careful assessment of the pulmonary venous connection is required in all patients with TOF since PAPVR can accelerate RV dilatation, RV dysfunction, and PR. As rerouting the anomalous pulmonary drainage to the hepatic vein, using the venous plexus between the hepatic veins should be considered.