Left hepatic vein draining into coronary sinus is a rare systemic
vascular anomaly. Its presence is significant when it is associated with
other cardiac lesions requiring surgery. We report technical challenges
in a case of persistent left superior vena cava and left hepatic vein
draining into coronary sinus in an adult with ostium secundum atrial
septal defect, which was repaired through minimally invasive approach.
Main technical challenge in this case was to achieve adequate venous
drainage, which was achieved by vacuum assistance and by manipulating
the position of femoral venous cannula. We approached through right
anterolateral thoracotomy, adequate venous drainage was achieved without
cannulating left hepatic vein or left superior vena cav.