We report on a 39-year-old female who had been operated on for an atri
al septal defect at the age of 14 years. On operation the inferior ven
a cava was iatrogenically misdirected into the left atrium. The cyanot
ic patient, in functional group IV of the NYHA classification, with po
lyglobulia and clubbing of the fingers was successfully reoperated aft
er 25 years.