Abstract
BACKGROUND: Persistent left superior vena cava (PLSVC), a relatively rare thoracic vascular malformation, can inconvenience perfusionists and operators when encountered during deep hypothermic circulatory arrest (DHCA). CASE SUMMARY: Herein, we describe the case of a patient with concurrent giant aortic arch aneurysm, aortic stenosis, and PLSVC. To treat these conditions, we performed right hemiarch and aortic valve replacements under DHCA. Notably, we applied "bilateral superior vena cava retrograde cerebral perfusion (RCP)" for cerebral protection, which significantly optimized the surgical procedure and reduced the risk of postoperative complications. The patient was discharged 14 d after surgery with no complications. CONCLUSION: Surgical intervention for PLSVC under DHCA can be performed using the bilateral superior vena cava RCP approach.