title: Device closure of patent ductus arteriosus in interrupted inferior vena cava.
abstract: BACKGROUND
  A 3-year-old child, weighing 8 kg, presented with patent ductus arteriosus (PDA) and interrupted inferior vena cava (IVC). The patient underwent successful PDA device closure via transjugular route after failing attempt at femoral venous route.
  
  
  METHODS
  PDA device closure was attempted via femoral venous route but could not be accomplished due to difficult curves to negotiate. Following this, PDA could be closed by device from jugular venous route with ease.
  
  
  CONCLUSIONS
  Interrupted IVC poses challenges for PDA device closure and various alternative routes are described like internal jugular, transhepatic, or femoral venous - azygous route. Our case describes difficulties associated with femoral venous route and advantages of jugular venous route in such cases.
  
  
  CONCLUSIONS
  Internal jugular access is a safe and feasible method of PDA device closure in cases of interrupted IVC even in smaller children.
authors.affiliation: Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India. Electronic address: drneeraj_12@yahoo.co.in.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Aggarwal
authors.affiliation: Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Mridul
authors.initials: M
authors.lastname: Agarwal
authors.affiliation: Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Raja
authors.initials: R
authors.lastname: Joshi
authors.affiliation: Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Reena K
authors.initials: RK
authors.lastname: Joshi
mesh_terms: D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007601:Jugular Veins; D055989:Septal Occluder Device; D054079:Vascular Malformations / Q000175:diagnosis* / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000002:abnormalities*
keywords: Device; Interrupted IVC; PDA; Transjugular; Vascular access