Inferior vena cava thrombosis-rope ladder sign.

Sascha Meyer,Martin Poryo

doi:10.1007/s10354-021-00886-y

Abstract

Congenital heart disease comprises one of the largest groups of congenital defects, affecting approximately 1% of births. Advances in pre- and postoperative critical care treatment as well as surgery and interventional procedures have improved survival rates, but treatment and long-term care of children with complex congenital heart disease remains challenging, and is associated with anumber of complications.Here, we report on a17-month-old infant with congenital univentricular heart disease who devloped post-operatively inferior vena cava (IVC) thrombosis. IVC thrombosis was confirmed by abedside contrast media study (X-ray) demonstrating collateral paravertebral circulation along the paravertebral sinuses bilaterally into the azygos and hemiazygos vein ("rope ladder sign"), with no contrast media detected in the IVC. The infant was subsequently started on aspirin and clopidogrel.

Highlights

After injection of contrast media, a conventional chest and abdominal X-ray demonstrated drainage of the contrast agent along the paravertebral sinuses bilaterally into the azygos and hemiazygos vein (“rope ladder” appearance), with no contrast media detected in the inferior vena cava (IVC) (Fig. 1)
Congenital heart disease comprises one of the largest groups of congenital defects, affecting approximately 1% of births [1]
Advances in pre- and postoperative critical care treatment as well as surgery and interventional procedures have led to increased survival rates, but treatment and long-term care of children with complex congenital heart disease remains challenging [2]

Summary

Introduction

Keywords Congenital heart disease · Children · Rope ladder sign · Thrombosis · Univentricular heart/ pathology We report the case of a 17-month-old infant who was initially treated with Damus–Kaye–Stansel surgery and Blalock–Taussig shunt for hypoplastic left heart syndrome (stage I palliation).

Results

Conclusion