A 4-year-old acyanotic child presented with recurrent respiratory tract infections and exertional dyspnea. Transthoracic echocardiography demonstrated a large ostium secundum atrial septal defect (ASD) with deficient rims and left to right shunting across the defect. There was presence of severe valvular pulmonic stenosis with a transvalvular gradient of 70 mm of Hg. There was mild tricuspid regurgitation with normal biventricular functions. A suspicion of an associated partial anomalous pulmon…