Anomalous systemic venous return to the right atrium is clinically innocuous and cause no functional disturbances or physiologic abnormalities by themselves and consequently require no treatment but may be surgical importance. We experienced a case of adult TOF combined with anomalous systemic venous drainage. Rudimentary right SVC with draining left sided vertical vein and IVC with separately drained left vein was revealed at operation time. With the bicaval cannulation, large sucker was used for drainage of blood from the left hepatic vein. Postoperative angiocardiogram showed above findings and combined double inferior vena cava at lumbar level.