Thomas Alvarado is a 9 month old boy from Ecuador. He developed congestive heart failure from a large hole between the pumping chambers. He had a pulmonary artery band operation in Guayaquil which helped control the heart failure. He presents for closure of the hole and removal of the band. Pre-operative evaluation at Wolfson Children's Hospital included a heart catheterization. This study was performed on May 10 and it demonstrated a more complex problem. Thomas actually has 2 holes between the pumping chambers and also has an abnormal pulmonary vein draining blood from the upper portion of the right lung to the right side of the heart (as opposed to the left side). Fortunately these new findings can be repaired when he has his open heart repair on May 15.