Severe pulmonary hypertension is a significant determinant of mortality following repair of total anomalous pulmonary venous drainage (TAPVD). Several strategies are used in its management. We describe the use of the ductus arteriosus in managing the postoperative pulmonary hypertension in these patients. Between 1996 and 2006, 28 patients underwent repair of TAPVD, 3 patients were managed by leaving the ductus arteriosus open to decompress the pulmonary artery. There were no deaths in this series. Decompression of the pulmonary artery by leaving the ductus arteriosus open is a useful maneuver in the early postoperative period in patients with persistent suprasystemic pulmonary artery pressure resulting in right ventricular decompensation.