Published online Nov 16, 2023. doi: 10.12998/wjcc.v11.i32.7858
Peer-review started: September 21, 2023
First decision: October 9, 2023
Revised: October 17, 2023
Accepted: November 3, 2023
Article in press: November 3, 2023
Published online: November 16, 2023
Processing time: 55 Days and 10.6 Hours
Persistent left superior vena cava (PLSVC), a relatively rare thoracic vascular malformation, can inconvenience perfusionists and operators when encountered during deep hypothermic circulatory arrest (DHCA).
Herein, we describe the case of a patient with concurrent giant aortic arch aneurysm, aortic stenosis, and PLSVC. To treat these conditions, we performed right hemiarch and aortic valve replacements under DHCA. Notably, we applied “bilateral superior vena cava retrograde cerebral perfusion (RCP)” for cerebral protection, which significantly optimized the surgical procedure and reduced the risk of postoperative complications. The patient was discharged 14 d after surgery with no complications.
Surgical intervention for PLSVC under DHCA can be performed using the bilateral superior vena cava RCP approach.
Core Tip: Persistent left superior vena cava (PLSVC) is a malformation that can coexist with the right superior vena cava without causing an imbalance in the hemodynamics, thereby concealing its detection during clinical consultation. We describe the case of a patient with an aortic arch aneurysm who also had PLSVC. When replacing the right hemiarch under deep hypothermic circulatory arrest, we utilized a “bilateral superior vena cava retrograde cerebral perfusion (RCP)” approach to PLSVC. The patient was discharged 14 d postoperatively without any complications. To the best of our knowledge, RCP via the bilateral superior vena cava has not previously been reported.