Right juxtaposition and a tunnel between the atrial appendages in a patient with atrial septal defect and pulmonary valve stenosis.

A 13-month-old boy with a diagnosis of atrial septal defect and pulmonary valve stenosis was admitted for corrective surgery. Right juxtaposition of the atrial appendages with a tunnel between the atrial appendages was detected during the surgery. The patient was operated successfully and had an uneventful recovery. Once right juxtaposition of the atrial appendages has been identified, the possibility of a "tunnel" communication between the appendages must be considered and ruled out.