Pulmonary venous obstruction (PVO) remains a major complication and the main cause of reoperation following repair of total anomalous pulmonary venous return (TAPVR). While a primary sutureless repair is preferred to address this pathology, employment of such a technique can be limited by distant PVO. We describe a repair to address hilar pulmonary vein obstruction in two patients with infradiaphragmatic TAPVR in whom a standard sutureless repair was not feasible. The repair is analogous to the Kasai repair for biliary atresia and involves a lung hilum Kasai-type anastomosis of either the atrium or conduit to address these challenges and add to the repertoire of the surgeon.