Anaesthetic Management of a Case of Minimally Invasive Surgical Repair of Sinus Venosus Atrial Septal Defect (SVASD) and Persistent Left Superior Vena Cava (LSVC), Assisted by Unique Bilateral Percutaneous Superior Vena Cava Cannulation

The most common venous abnormality of the thorax is persistent left superior vena cava (LSVC), incidence being less than 0.5%. Of all the congenital heart anomalies, the sinus venosus type of atrial septal defect (SVASD) is most commonly associated with LSVC and accounts for 4-10% of all ASD. We report a 52-year-old male patient with a SVASD with LSVC and PAPVC, who underwent minimally invasive cardiac surgical (MICS) repair of the same, assisted by unique bilateral percutaneous SVC cannulation and had an uneventful course and recovery. Presence of LSVC usually requires sternotomy and its drainage either by direct cannulation or passive decompression. Bilateral percutaneous large bore cannulation of the right and left SVC for venous drainage to facilitate MICS for such case has not been reported in literature till date. Utmost care and transesophageal echocardiographic guidance has to be taken not to damage coronary sinus during cannulation.