scholarly journals A case report of an interrupted inferior vena cava and azygos continuation: implications for preoperative screening in minimally invasive cardiac surgery

2021 ◽  
Author(s):  
Wiebe G Knol ◽  
Frans B Oei ◽  
Ricardo P J Budde ◽  
Maarten ter Horst
Keyword(s):  
Cardiac Surgery ◽  
Inferior Vena Cava ◽  
Minimally Invasive ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Vena Cava ◽  
Minimally Invasive Cardiac Surgery ◽  
Azygos Continuation ◽  
Venous Cannula ◽  
The Right

Abstract Background Femoral cannulation is commonly used in minimally invasive cardiac surgery to establish extracorporeal circulation. We present a case with a finding that should be evaluated when screening candidates for minimally invasive cardiac surgery. Case presentation A 57-year-old male patient was scheduled for minimally invasive repair of the mitral and tricuspid valve and a MAZE-procedure. During surgery there was difficulty advancing the venous cannula inserted in the right femoral vein. On transesophageal echocardiography a guidewire advanced from the femoral vein was observed entering the right atrium from the superior vena cava. Despite inserting a second venous cannula in the jugular vein, venous drainage was insufficient for minimal invasive surgery. The approach was converted to a median sternotomy with bicaval cannulation. Re-examination of the preoperative computed tomography scan showed an interrupted inferior vena cava with azygos continuation. Discussion In patients with major venous malformations such as the interrupted inferior vena cava with azygos continuation a full sternotomy is the preferred approach. The venous system should be evaluated when screening candidates for minimally invasive mitral valve surgery with preoperative computed tomography. Additional cues to suspect interruption of the inferior vena cava are polysplenia and a broad superior mediastinal projection on the chest radiograph, mimicking a right paratracheal mass.

scholarly journals First Resection of a Cavoatrial Renal Tumor Thrombus in a Pediatric Patient in Central America Based on a Multistage Surgical Safety Strategy Combining Liver Transplant Techniques and Cardiac Surgery

2021 ◽  
pp. 47-55
Author(s):  
Edward Castro-Santa ◽  
Hellen Daniela Siles-Víquez ◽  
Karla Castro-Solano ◽  
Javier Brenes-González ◽  
María A. Matamoros
Keyword(s):  
Cardiac Surgery ◽  
Inferior Vena Cava ◽  
Pediatric Patient ◽  
Inferior Vena ◽  
Renal Tumor ◽  
Vena Cava ◽  
Surgical Safety ◽  
Chiari Syndrome ◽  
The Right ◽  
Safety Strategy

We herein report the challenging evaluation and planning process involved in performing the first successful surgical resection of a renal tumor with extensive inferior vena cava tumor thrombosis reaching the right atrium in a pediatric patient within the Central American region. In November 2018, the Oncology Department of the National Children’s Hospital in Costa Rica consulted our Center for Liver Transplantation and Hepatobiliary Surgery for the evaluation of a clinical case involving a 6-year-old female patient with progressive Budd-Chiari syndrome caused by a Wilms’ tumor of the right kidney with tumor thrombosis of the inferior vena cava reaching the right atrium. A multistage surgical safety strategy combining liver transplant techniques and cardiac surgery was thereafter designed and implemented, achieving complete excision of the tumor thrombus from the inferior vena cava with right nephrectomy. Postoperatively, the patient exhibited complete clinical resolution of Budd-Chiari syndrome and has remained tumor free with excellent quality of life while pursuing her second grade of primary school education 22 months after the successful implementation of this multistage surgical safety strategy. The combination of liver transplantation techniques and cardiac surgery based on a multistage surgical safety strategy minimized the occurrence of unexpected intraoperative events and allowed for complete renal tumor resection and level IV thrombectomy for the first time in a pediatric patient of a public health system in a developing country within the Central American region.

scholarly journals A case report of simultaneous mini-invasive treatment of a patient with kidney tumor and tumor thrombus in inferior vena cava

2018 ◽  
Vol 22 (3) ◽  
pp. 69
Author(s):  
M. S. Mosoyan ◽  
M. A. Chernyavskiy ◽  
A. V. Chernov ◽  
M. E. Mamsurov ◽  
I. O. Chuykova
Keyword(s):  
Informed Consent ◽  
Inferior Vena Cava ◽  
Minimally Invasive ◽  
Conflict Of Interest ◽  
Inferior Vena ◽  
Vena Cava ◽  
Kidney Tumor ◽  
Invasive Treatment ◽  
Rehabilitation Period ◽  
The Right

<p>Nowadays, there is a tendency in surgery to use more minimally invasive surgical procedures to decrease the risk of intra- and postoperative complications and to reach a faster rehabilitation period. We report a case of successful simultaneous minimally invasive treatment of a patient with kidney tumor. According to ultrasound examination data, the patient had a tumor in the right kidney. A computed tomography scan of the abdomen verified the tumor and detected a thrombus in the inferior vena cava lumen. Embolization of the right renal artery was performed as the first stage in the hybrid operating room. Right-side nephrectomy and thrombectomy from inferior vena cava, as the second stage, were done by using a robotic surgical system. The feature of this case is that embolization and nephrectomy were simultaneously performed during one surgical procedure. On the 10th day, the patient was discharged from the hospital without any signs of deterioration and complications. Thus, the unique work of two surgical teams proficient in mini-invasive technologies allowed to eliminate tumors and tumor thrombi in a single procedure and to reduce the bleeding, in-hospital stay, and rehabilitation period. This method will help more patients with kidney tumors in the future.</p><p>Received 28 June 2018. Revised 3 August 2018. Accepted 6 August 2018.<br /><strong>Informed consent:</strong> The patient’s informed consent to use his records for medical purposes is obtained.<br /><strong>Funding:</strong> The study did not have sponsorship.<br /><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p>

scholarly journals Embryological and surgical considerations of absent infra-renal part of inferior venacava and left renal vein

2020 ◽  
Vol 11 (5) ◽  
pp. 83-86
Author(s):  
Indira CK ◽  
Arunkumar KG
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Left Renal Vein ◽  
Abdominal Cavity ◽  
Vena Cava ◽  
Complex Process ◽  
Long Course ◽  
The Right

Background: Development of inferior vena cava (IVC) is a complex process that involves the anastomoses between three pairs of embryonic veins. Specific permutations exist in the venous plane of the abdomen and pelvis resulting in variations such as single left IVC, double IVC, and left renal retroaortic vein. Anomalies of the inferior vena cava and renal veins occur infrequently but may contribute to serious morbidity throughout surgical exploration if unidentified. Most anomalies remain asymptomatic until surgical intervention or clinical presentation with thromboembolic complications. Aims and Objective: Our research is aimed to link embryology with developmental disorder and the complications associated with the anomalous vessels in the field of surgery. Materials and Methods: Ten IUD fetuses (ranging from 20 weeks to term fetuses) were collected from the O&G department of the college and injected locally with dilute formalin and placed in containers filled with formalin. Dissection of the fetuses was done to identify congenital anomalies. Results: The external appearance of the 28-week-old fetus showed no gross anomaly. Examination abdominal cavity showed absent infrarenal segment of IVC and left renal vein. The right renal vein was seen running a long course to the left side with tributaries of lumbar veins and was seen continuing as the left femoral vein medial to the femoral artery. Segments of suprarenal and renal IVC were present. Conclusion: Correlating anomalies and variations of IVC and its tributaries to embryology. However, understanding of such anomaly is necessary to avoid significant diagnostic pitfalls and in preoperative surgicaland radiological intervention planning.

Venous drainage for minithoracotomy approach in an adult with interrupted inferior vena cava

2021 ◽  
pp. 021849232110170
Author(s):  
Toshitaka Watanabe ◽  
Kazuma Okamoto ◽  
Nobuyuki Yoshitani ◽  
Ryo Tohma ◽  
Takuya Misato ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Right Atrium ◽  
Septal Defect ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Vena Cava ◽  
Venous Drainage ◽  
Preoperative Imaging ◽  
Atrial Septal Defect Closure ◽  
The Right

For atrial septal defect closure via right minithoracotomy in an adult patient with infra-hepatic interruption of the inferior vena cava with azygos connection, an alternative venous cannulation strategy was applied. In addition to bicaval cannulations to the femoral vein and the internal jugular vein, a 20 Fr straight cannula draining the hepatic vein was added to the proximal IVC through the right atrium wall via a working port. A bloodless operative field in the right atrium was afforded with bicaval encircling. Preoperative imaging test of the continuity of the IVC was important planning cardiac surgery with peripheral cannulations.

scholarly journals Inferior Vena Cava Duplication: Incidental Case in a Young Woman

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Danilo Coco ◽  
Sara Cecchini ◽  
Silvana Leanza ◽  
Massimo Viola ◽  
Stefano Ricci ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Surgical Interventions ◽  
Azygos Continuation ◽  
Vascular Structures ◽  
Double Inferior Vena Cava ◽  
The Right

A case of a double inferior vena cava (IVC) with retroaortic left renal vein, azygos continuation of the IVC, and presence of the hepatic portion of the IVC drained into the right renal vein is reported and the embryologic, clinical, and radiological significance is discussed. The diagnosis is suggested by multidetector computed tomography (MDCT), which reveals the aberrant vascular structures. Awareness of different congenital anomalies of IVC is necessary for radiologists to avoid diagnostic pitfalls and they should be remembered because they can influence several surgical interventions and endovascular procedures.

scholarly journals Minimally invasive congenital cardiac surgery with unsnared inferior vena cava

2020 ◽  
Author(s):  
Alvise Guariento ◽  
Claudia Cattapan ◽  
Francesco Bertelli ◽  
Vladimiro Vida
Keyword(s):  
Cardiac Surgery ◽  
Inferior Vena Cava ◽  
Minimally Invasive ◽  
Inferior Vena ◽  
Vena Cava ◽  
Congenital Cardiac Surgery

scholarly journals Clinical Insight into the Precaval Right Renal Artery: A Multidetector Row Computed Tomography Angiographic Study

ISRN Anatomy ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Shubha Srivastava ◽  
Indra Kumar ◽  
C. S. Ramesh Babu ◽  
K. K. Gupta ◽  
O. P. Gupta
Keyword(s):  
Computed Tomography ◽  
Inferior Vena Cava ◽  
Minimally Invasive ◽  
Renal Artery ◽  
Inferior Vena ◽  
Vena Cava ◽  
Multidetector Row Computed Tomography ◽  
Renal Vasculature ◽  
Multidetector Row ◽  
The Right

Variations of course and number of renal vessels are not so uncommon and their knowledge is important for planning of minimally invasive renal surgeries. The earlier literature reports a prevalence of precaval right renal artery between 0.8% and 5%. Normally, the right renal artery passes posterior to the inferior vena cava, but it can also be precaval where it passes anterior to inferior vena cava. The multidetector row contrast enhanced computed tomography angiography allows precise evaluation of renal vasculature. The aim of this retrospective study is to determine the prevalence of precaval right renal artery. Amongst 73 MDCT scans studied, we identified 4 cases of precaval right renal artery with the prevalence being 5.48%, more than what is reported in the earlier literature. We also report a single and dominant precaval right renal artery in one of the cases, which is a rare finding. On the basis of these results, we conclude that precaval right renal artery appears to be more common and so the knowledge of this variant holds a major clinical implication in preventing misinterpretation of radiological images and proper planning of interventional procedures and minimally invasive surgeries.

Abstract 17133: Complete Inferior Vena Cava Thrombosis In A Sickle Cell Patient With Suspected May Thurner Syndrome

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Matthew T Finn ◽  
Erika Rosenzweig ◽  
Mariel Turner ◽  
Ajay J Kirtane ◽  
Sahil Parikh ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Inferior Vena Cava ◽  
Sickle Cell ◽  
Right Atrium ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Vena Cava ◽  
Iliac Vein ◽  
Thrombus Removal ◽  
The Right

Case Presentation: 19 year old woman with sickle cell anemia and nephrotic syndrome presented with leg and back pain. While treated for vaso-occlusive crisis, patient developed dyspnea and chest pain. She underwent CT chest which revealed a right lower lobe pulmonary embolism. The patient was started on anticoagulation. Her transthoracic echocardiography revealed normal right heart function but nearly occlusive inferior vena cava (IVC) thrombus just distal to the right atrium. Subsequently a CT venogram demonstrated extensive thrombus from the left external iliac vein to the right atrium as well as compression of the left common iliac vein. Multidisciplinary discussion was performed to discuss options including medical therapy, surgical removal, or catheter-based removal. Given concern for further pulmonary embolization, patient underwent catheter based thrombus removal. A 26 french access was obtained in the right internal jugular vein and a 17 french access was obtained in the right femoral vein. Using the Angiovac system, mechanical thrombectomy was performed in the IVC. The angiovac system is a 24 french suction catheter with filtration and reperfusion through the right femoral vein. Limited thrombus removal was achieved. Next,14 french left femoral vein access was obtained and the Inari Clottriever device was used to mechanically score and remove a significant amount of thrombus (Figure 1). Post removal angiography revealed a patent IVC with minimal residual thrombus. Discussion: IVC thrombosis is a rare presentation of venous thromboembolism (VTE). This patient had multiple reasons for VTE including nephrotic syndrome and likely May Thurner Syndrome (MTS). MTS is an underdiagnosed entity resulting in mechanical compression of the left iliac vein in upto 50% of patients presenting with left lower extremity VTE. While proximal extension of thrombus is rare as seen in this case, high clinical suspicion is warranted for accurate diagnosis and treatment.

Atrial Septal Defect Closure via Left Subclavian Vein Approach in a Patient With Absent Inferior Vena Cava

2021 ◽  
pp. 215013512098380
Author(s):  
Yusuke Enta ◽  
Shunsuke Tatebe ◽  
Yoshikatsu Saiki ◽  
Norio Tada
Keyword(s):  
Inferior Vena Cava ◽  
Atrial Septal Defect ◽  
Subclavian Vein ◽  
Septal Defect ◽  
Inferior Vena ◽  
Transcatheter Closure ◽  
Vena Cava ◽  
Atrial Septal Defect Closure ◽  
Azygos Continuation ◽  
Left Subclavian Vein

Without the femoral venous approach, transcatheter closure of an atrial septal defect is challenging. We performed percutaneous closure via the left subclavian vein in a patient with absence of the inferior vena cava with azygos continuation. Considering that inferior vena cava anomalies are not extremely rare among those with congenital heart disease, the left subclavian vein approach can be an alternative to the femoral approach.

scholarly journals Emphysematous pyelonephritis with air bubble in the inferior vena cava

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Tiffany A. Perkins ◽  
Alberic Rogman ◽  
Murali K. Ankem
Keyword(s):  
Septic Shock ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Rare Presentation ◽  
Emphysematous Pyelonephritis ◽  
Case Presentation ◽  
Air Bubble ◽  
First Case ◽  
The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

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