Accessory Right and Left Hepatic Arteries in a 69 year-old White Female Donor with a Duplicated Inferior Vena Cava: Anatomical and Surgical Significance

Abstract

Hepatic artery variations are relatively common findings in patients with an array of findings that were categorized and quantified in the Michels classification system. Findings of an accessory right and left hepatic artery were found in a 69 year-old white female donor with a duplicated inferior vena cava during routine anatomical dissection (Michels type 7 variation). Research supports that the hepatic artery variations can be due to either failure of regression of ventral anastomosis between the dual aortas or failed regression of fetal hepatic blood flow. Given the concurrent development of the IVC and aortic branches during the fourth to seventh week of gestation, this patient’s duplicated IVC and abnormal CT and SMA anatomy are likely related, both a result of failure of regression of fetal vasculature. There are no known associated comorbidities with this vascular variation however it is clinically significant when undergoing any hepatobiliary surgical procedures and suggests an increased risk for hepatic ischemic events.