Anomalous drainage of the inferior caval vein to the left atrium

We report a girl, aged 11(7/12) years, who presented with cyanosis. Cardiac catheterization showed occlusion of the infrahepatic segment of the inferior caval vein, with drainage of the hepatic veins into the left atrium. Transoesophageal echocardiography revealed an anomalous Eustachian valve that baffled the vein to the left atrium. This lesion is an extremely rare cause of cyanosis.