Percutaneous transhepatic atrial septal defect closure in a child with total anomalous vena caval connection

A total anomalous systemic venous connection to the coronary sinus is a rare anomaly, and transcatheter interventions in such patients are challenging due to the lack of a direct entryway into the heart. We describe a patient with a unique systemic venous anatomy and the successful closure of her atrial septal defect via a transhepatic approach.