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Suprarenal interrupted inferior cava with azygos continuation in a patient with pulmonary embolism: a case report.

Eur Heart J Case Rep

November 2024

Department of Cardiology, Rhythmology, Angiology and Intensive Care Medicine, Heart Center Osnabrueck, Hospital Osnabrueck, Westphalian Wilhelms University of Muenster, Osnabrueck, Germany.

Background: Interrupted inferior vena cava (IVC) is a rare developmental defect characterized by azygos continuation following failure of fusion of one or more of the component parts of the embryological IVC. It occurs in approximately one in 5000 of the general population. It is usually an isolated finding and is generally asymptomatic.

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Background: The azygos vein (AV) plays a crucial role in the mediastinal region, exhibiting considerable variability in its anatomy and relationship with surrounding structures. This study aims to assess the morphometry and anatomy of the AV through a comprehensive meta-analysis of studies reporting extractable data on this vessel.

Materials And Methods: Major online medical databases such as PubMed, Scopus, ScienceDirect, Web of Science, SciELO, BIOSIS, Current Content Connect, Korean Journal Database and Wiley online library were searched to gather all relevant studies regarding the anatomical characteristics of the AV.

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Article Synopsis
  • * This paper discusses a case where a patient had both an interrupted IVC and a persistent LSVC, along with a heart rhythm problem called Atrioventricular nodal reentrant tachycardia (AVNRT).
  • * The patient underwent successful treatment for AVNRT using radiofrequency catheter ablation accessed through the left subclavian vein.
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Article Synopsis
  • * High-resolution imaging techniques allowed detailed evaluation of the absence, showing a dilated hemiazygos vein connecting to the left brachiocephalic vein.
  • * This patient benefited from advanced imaging methods, which produced high-quality anatomical insights while reducing radiation exposure compared to standard CT scans.
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Key Clinical Message: Because of the complex embryonic origin of the abdominal venous structures, IVC and azygous systems can show numerous and even previously unreported anatomical variations and anomalies. Also, evaluating major vascular structures should not be dismissed in non-contrast-enhanced CT as it can provide valuable information about these structures.

Abstract: Double IVC is a rare occurrence of IVC anatomical variations and congenital anomalies.

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