Intraoperative recognition of persistent left superior vena cava during right internal jugular central line placement in mitral valve replacement: a case report

When transesophageal echocardiography fails to confirm central venous catheter position despite proper technique, rare anatomical variants such as persistent left superior vena cava should be considered. Employing targeted transesophageal echocardiography interrogation of the coronary sinus and adjunctive imaging modalities can facilitate prompt recognition. Awareness of persistent left superior vena cava prevents unnecessary catheter manipulation, reduces procedural delays, and enhances patient safety during cardiac surgery.