We describe a male pediatric patient aged about 12 years weighing 32kg, who had Double outlet right ventricle with Ventricular septal defect and Pulmonary stenosis along with idiopathic thrombocytopenic purpura. He had undergone Bi-directional Glenn surgery 7years back and now presented for cardiac catheterization for evaluation of feasibility for Fontan surgery. The procedure was planned to be performed under sedation.

During the procedure there was rupture of one right major aortopulmonary collateral, leading to massive hemoptysis necessitating immediate emergency intubation and intermittent positive pressure ventilation. This was followed by isolation of right lung using a left double lumen tube. After stabilization of the airway and hemodynamics, the ruptured right major aortopulmonary collateral was occluded by vascular plug.

The patient was conservatively managed in the intensive care unit and extubated after 48 hours and discharged from the hospital one week later in a stable condition and was advised follow up for Fontan surgery.