Successful blood sampling through azygos continuation with interrupted inferior vena cava. A case report and review of the literature.
Interrupted inferior vena cava (IVC) with azygos continuation is a rare congenital anomaly, and is frequently associated with other cardiovascular malformations and situs anomalies, such as left isomerism. These patients usually develop deep vein thrombosis (DVT), and asymptomatic patients above 60 years of age are very rare. Here we report a case of interrupted IVC which we diagnosed in a 72-year-old woman. She was admitted to our hospital suffering from heart failure and supraventricular tachycardia. Echocardiography detected secundum atrial septal defect (ASD). An abnormal paravertebral pleural line on the chest X-rays indicated the existence of venous anomaly. Anatomical images obtained by Multidetector Computed Tomography (MDCT) helped us to successfully perform right heart catheterization procedures through azygos continuation including blood sampling from pulmonary veins. Even in elderly patients, a careful examination of chest X-rays can indicate undiagnosed venous anomalies; thus, it is critically important before planning surgical or interventional procedures.
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Tetsuya
T
Saito
Masafumi
M
Watanabe
Toshiya
T
Kojima
Takayoshi
T
Matsumura
Hideo
H
Fujita
Arihiro
A
Kiyosue
Masao
M
Takahashi
Norihiko
N
Takeda
Koji
K
Maemura
Hiroshi
H
Yamashita
Yasunobu
Y
Hirata
Shuhei
S
Komatsu
Kuni
K
Ohtomo
Ryozo
R
Nagai
D000368:Aged; D001401:Azygos Vein; D001800:Blood Specimen Collection / Q000379:methods*; D006328:Cardiac Catheterization; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis*; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis*; D059446:Heterotaxy Syndrome / Q000175:diagnosis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D061330:Multidetector Computed Tomography; D011667:Pulmonary Veins; D013617:Tachycardia, Supraventricular / Q000175:diagnosis*; D014682:Vena Cava, Inferior / Q000002:abnormalities*