Left superior vena cava (LSVC) to the left atrium is a rare congenital card
iac complex, which may appear as an isolated anomaly, or as part of more co
mplex cardiac anomalies. Traditionally, an intraatrial baffle was the prefe
rred surgical technique. Although this technique has proved reliable and su
ccessful, acute ligation and extracardiac repair are simpler and easier sol
utions, requiring less myocardial ischemic time. We present 3 patients who
underwent simple ligation and discuss the literature for other extracardiac
options of surgical repair. Our patients had short transient congestion in
the left upper part of their body that resolved completely after a few wee
ks, without further complications. We believe that either acute ligation or
extracardiac repair is a much simpler yet effective solution to divert the
left caval flow to the lesser circulation. (C) 1999 by The Society of Thor
acic Surgeons.