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Persistent left superior vena cava (PLSVC) is a rare anatomic variant that has a significant effect on the structure of the heart and venous system with clinical implications that are far-reaching. The presence of this variant is relevant to central venous catheter insertion, cardioverter-defibrillator placement, coronary artery bypass grafting, and numerous other medical procedures. In this report, we describe a rare case of PLSVC with a connection to the azygos system; notably, the vast majority of PLSVCs connect to the coronary sinus. We also discuss the anatomic and anesthetic considerations for individuals with this uncommon variant.

Persistent Left Superior Vena Cava (PLSVC) with a Connection to the Azygos System: Case Report and Clinical Implications