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Case Report, There is no consensus regarding the ideal surgical procedure for treatment of combined atrial septal defect without an inferior septal rim and partial anomalous right lower pulmonary venous connection. A 41 year-old woman had previously undergone ineffective surgical closure of an ostium secundum-type atrial septal defect. Intraoperatively, we ascertained the correct diagnosis of partial anomalous right lower pulmonary venous connection combined with a residual defect. Incision of the atrial septal wall up to the superior margin along the previous suture line yielded a flap adequate for the atrial septal wall, and this flap was slid again into the entire opening. The spatially complex intracardiac lesion was repaired by using only autologous tissue.