The Surgical Management of Persistent Left Superior Vena Cava Draining into the Left Atrium1

Persistence of a left superior vena cava with unroofing of the coronary sinus appears to be due to a single developmental complex. The functional effect is a left‐to‐right transatrial shunt associated with systemic arterial desaturation. Three cases treated surgically at the Royal Children's Hospital are reported. A well‐developed innominate vein allowed simple ligation of the persistent left superior vena cava and closure of the septal defect in one, but the other two required insertion of an intraatrial baffle in such a manner as to redirect the venous return to the right atrium.