Persistent left superior vena cava with patent left innominate vein: Ideal anatomy for mini invasive thoracoscopic ligature

Persistent left superior vena cava is the most common congenital anomaly of the thoracic venous system. In most cases, the left vena cava drains into the coronary sinus and remains asymptomatic. When draining in the left atrium, paradoxical embolization could be a severe complication of the right-to-left shunt and is an indication for surgery. We describe the thoracoscopic approach for ligation of a persistent left superior vena cava in a 9 years old girl with VACTERL association and a history of stroke. Bilateral superior vena cava connected by a bridging vein allowed simple ligature of the abnormal systemic venous return.