We report the case of a 62-year-old male patient, admitted for aortic valve replacement. Bilateral common carotid artery occlusion and bilateral internal carotid artery occlusion have been reported, as well as right vertebral artery occlusion. Aortic valve replacement was performed in the standard fashion using the cardiopulmonary bypass. No neurological deficit was apparent on emergence from anesthesia. Keywords: bilateral carotid occlusion, the vertebral artery occlusion, cardiac surgery

A persistent left superior vena cava is relatively common venous anomaly. But, the presence of persistent left superior vena cava with the atresia of the right superior vena cava is a much rarer situation. The association of these anomalies with the drainage of the left hepatic vein into the right atrium is an extremely rare situation. Here we present one such case in the situs solitus and normocardia.