Division of venous collateral after Glenn shunt by minimally invasive surgery

An infant with cyanotic heart disease that was palliated with a bidirectional cavopulmonary shunt developed progressive cyanosis 3 months after the surgical procedure. A large hemiazygous vein was found to be decompressing the bidirectional Glenn shunt from the left innominate vein and was ligated using video-assisted thoracoscopic surgery. The unusually rapid appearance of the shunt, and the excellent outcome associated with the video-assisted thoracoscopic surgery procedure are discussed.