Patent ductus arteriosus with hemiazygos communication to left superior vena cava

We experienced the ligation of patent ductus arteriosus (PDA) via the left thoracotomy in a 24-day-old infant with inferior vena cava defect and hemiazygos communication to a persistent left superior vena cava (LSVC). Although the large hemiazygos vein (HAzV) crossed just in front of PDA, its mobilization enabled the smooth ligation of PDA without hemodynamic instability. The postoperative course was uneventful.