RESUMEN
Persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly that is often detected incidentally during cardiovascular imaging or interventions. Coexisting PLSVC with mitral regurgitation (MR), aortic stenosis (AS), aortic regurgitation (AR), and complete heart block (CHB) are exceptionally rare and have not been reported in the literature to our knowledge. We present the case of a 50-year-old male with PLSVC coexisting with severe MR, mild AS/AR, and CHB who successfully underwent permanent pacemaker (PPM) implantation and mitral valve replacement. Comprehensive diagnostic evaluation and tailored management strategies are crucial for achieving significant improvement in the patient's symptoms. The presence of PLSVC adds complexity to diagnosis and management, necessitating multidisciplinary collaboration for optimal patient care.