Anomalous left hepatic vein to coronary sinus in a patient with atrial septal defect: Minimally invasive approach;...

Area of Science:

• Cardiovascular Surgery
• Anatomical Variations
• Medical Imaging

Background:

• Persistent left superior vena cava and anomalous hepatic venous drainage are rare congenital anomalies.
• The left hepatic vein draining into the coronary sinus is a significant finding, especially when associated with cardiac defects requiring surgical intervention.

Observation:

• This report details a case of a persistent left superior vena cava and left hepatic vein draining into the coronary sinus in an adult patient.
• The patient also had an ostium secundum atrial septal defect that necessitated surgical repair.

Findings:

• The surgical team employed a minimally invasive approach via right anterolateral thoracotomy.
• Key technical challenges included ensuring adequate venous drainage, which was managed using vacuum assistance and strategic femoral venous cannula positioning.
• Successful repair was achieved without the need to cannulate the anomalous left hepatic vein or persistent left superior vena cava.

Implications:

• This case demonstrates the feasibility of minimally invasive surgical correction for complex congenital heart disease involving rare systemic venous anomalies.
• Effective management strategies for venous drainage are crucial for successful outcomes in such cases.
• Highlights the importance of pre-operative imaging and surgical planning for rare vascular anomalies.