biostudies-literatureUnknown6(10)Duong P<h4>Background</h4>Persistent left superior vena cava (LSVC) with connection to the left atrium (LA) is a rare anomaly with serious clinical implications. Depending on the direction of flow through the intracardiac shunt, clinical presentation varies from cyanosis or paradoxical embolism to overt right heart failure.<h4>Case summary</h4>A 26-year-old man with repaired ventricular septal defect (VSD) during infancy presented with symptoms of progressive exercise intolerance. Cardiac imaging revealed a large defect at the posterior wall of the LSVC above its entry to the coronary sinus (CS), connecting the LSVC with the LA and resulting in diversion of pulmonary venous return to the CS. All pulmonary veins connect normally to the LA. The large left-to-right intracardiac shunt led to significEuropean heart journal. Case reportsytac382https://www.ebi.ac.uk/biostudies/studies/S-EPMC9549595biostudies-literatureCase report of a left superior vena cava to left atrial connection treated with percutaneous covered stent placement.PMC9549595Duong PMoharam-Elgamal SKang SLPapaioannou VfalseCase report of a left superior vena cava to left atrial connection treated with percutaneous covered stent placement.<h4>Background</h4>Persistent left superior vena cava (LSVC) with connection to the left atrium (LA) is a rare anomaly with serious clinical implications. Depending on the direction of flow through the intracardiac shunt, clinical presentation varies from cyanosis or paradoxical embolism to overt right heart failure.<h4>Case summary</h4>A 26-year-old man with repaired ventricular septal defect (VSD) during infancy presented with symptoms of progressive exercise intolerance. Cardiac imaging revealed a large defect at the posterior wall of the LSVC above its entry to the coronary sinus (CS), connecting the LSVC with the LA and resulting in diversion of pulmonary venous return to the CS. All pulmonary veins connect normally to the LA. The large left-to-right intracardiac shunt led to signific2022-01-01T00:00:00Z2022 Oct2025-04-05T12:18:14.054Z2025-04-05T12:18:14.054ZS-EPMC95495953622581110.1093/ehjcr/ytac382