Persistent left superior vena cava draining into the left atrium is a rare congenital venous anomaly, which remains asymptomatic and therefore undetected in most cases. Paradoxical embolization caused by right-to-left shunt is a severe complication and requires surgical correction. We describe the first thoracoscopic approach for ligation of a persistent left superior vena cava even though our patient had severe kyphoscoliosis because of Klippel-Feil syndrome.
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