Minimally invasive cardiac surgery for mitral regurgitation complicated by absence of right superior vena cava and persistent left superior vena cava.

A 51-year-old man with severe mitral regurgitation was admitted. While undergoing preoperative examination for mitral disease, he was found to have absence of the right superior vena cava and a persistent left superior vena cava. Minimally invasive cardiac surgery (MICS) was performed through a right anterior thoracotomy. Cardiopulmonary bypass was established with venous drainage through the internal jugular and right femoral veins and arterial return through the right femoral artery. There were no difficulties during the operation. Isolated persistent left superior vena cava is very rare, but if it is diagnosed preoperatively and an appropriate operative plan is made, MICS can be performed safely.