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Labor and delivery greatly stress the cardiovascular system. In this patient with underlying congenital heart disease and congestive heart failure, hemodynamic stability was maintained with a combination of lumbar epidural and caudal epidural anesthesia.
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We describe an extremely unusual case, with isolated left superior vena cava to the left atrium, normal intracardiac anatomy, and left juxtaposition of the atrial appendages. Surgical repair was performed without cardiopulmonary bypass by anastomosing the left superior cava to the superior aspect of the right atrial appendage, and was facilitated by the ectopic location of the appendage.
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