A 6-day-old neonate with cyanosis and tachypnea was found to have total anomalous pulmonary venous connection below diaphragm by two-dimensional echocardiography. Emergency operation was performed successfully with cardiopulmonary bypass at moderate hypothermia. Postoperatively continuous peritoneal dialysis was used for acute renal failure and tracheal intubation was required for 10 days. The patient is doing well and showing normal physical and mental development at 7 months of age. Emergency operation should be performed in patients with infradiaphragmatic total anomalous pulmonary venous connection.
