Left-sided Inferior Vena Cava Research Articles

Transposition of Abdominal Inferior Vena Cava to the Left: A Rare Case Report

Development of the vascular system in humans is a complex process that involves formation, retention, regression, and reconnection of primitive vascular channels, ultimately forming a definite pattern of the venous vascular architecture. Any errors in these processes would lead to anomalous venous structures, which would pose severe diagnostic and therapeutic challenges. Herein, we report a case of left-sided inferior vena cava that was noticed in the posterior abdominal wall of a male cadaver aged about 80 years. Although venous anomalies are common in their occurrence, a left-sided transposition of the inferior vena cava is a rare and significant finding in retroperitoneal surgeries because this can be misdiagnosed as para-aortic lymphadenopathy, a tumor or dilated gonadal vein that may result in iatrogenic damage during surgeries. The unusual location and course of the inferior vena cava and its embryological basis are discussed in this case.

Right-Sided May-Thurner Syndrome in a Patient with Left-Sided Inferior Vena Cava and Recent COVID-19 Infection

Background: May-Thurner Syndrome (MTS) is a rare vascular condition where the left common iliac vein is compressed between the right common iliac artery and the spine. We report a case of a patient with a left-sided inferior vena cava and right-sided May-Thurner syndrome. He had recent symptomatic COVID infection despite vaccination (Janssen). Case: A 28-year-old male presented with right lower extremity pain and swelling for three weeks. A duplex ultrasound was performed revealing iliofemoral deep vein thrombosis. Pharmacomechanical thrombectomy with ultrasound assisted thrombolysis was performed with subsequent femoral venogram and angioplasty of the right common iliac vein. Conclusion: May-Thurner Syndrome often remains underdiagnosed due to the chronic nature of the disease process. The presence of a left-sided IVC leading to right sided MTS with recent COVID-19 infection (and vaccination) was a unique feature of this case. May-Thurner Syndrome should be considered in the differential diagnosis of those present with DVTs or symptoms of venous hypertension.

Duplicated inferior vena cava in live-related renal transplant donor nephrectomy

Evaluation for prospective donors in live-related renal transplantation poses many challenges. Anatomical anomalies are no longer considered red flags as long as the functionality is maintained. Vascular anomalies increase difficulty during live donor nephrectomy. We herein report a case of live donor nephrectomy in a donor with a duplicated left-sided inferior vena cava (IVC). Adequate length of the left renal vein was got by taking a cuff off the duplicated IVC. The postoperative period was uneventful. Duplicated IVC is not a contraindication for left donor nephrectomy and detailed preoperative imaging helps in delineating and planning such cases.

An unexpected route of temporary pacing lead.

Congenital anomalies of the venous system including superior (SVC) and inferior vena cava are not uncommon. Failure of certain vessels embryogenesis results in numerous caval variations and anomalies. Anomalies of systemic venous circulation are frequently seen in patients with congenital heart disease and are sometimes incidentally recognized. However, these are usually without significant clinical implications, detection of these anomalies is necessary to avoid diagnostic pitfalls and for planning vascular interventions. We present a rare caval anomaly, a left-sided IVC with hemiazygos continuation to left SVC and coronary sinus.

A rare case of left inferior vena cava presenting with May-Thurner syndrome

BackgroundMay–Thurner anomaly is characterized as external venous compression by the arterial framework against hard bony structures. This chronic anatomical lesion infrequently leads to deep vein thrombosis in the lower extremity, and it may lead to leg swelling as a long-term post-thrombotic complication. Left iliac vein compression may not be as uncommon as was previously thought, and it typically occurs in women more than men. Congenital anomalies of venous tree are not rare; they exist in 8.7% of the general population.Case-presentationWe herein present the first case of right-sided May Thurner Syndrome in a patient with IVC anomalies. In our patient, both common iliac veins formed the left-sided IVC, which extended to the hemiazygos vein and the superior vena cava. Additionally, there was a right-sided suprarenal IVC, which extended to the right atrium.ConclusionUnderstanding the proper anatomy in May-Thurner syndrome helps in better decision making for management of disease pathophysiology.

An unusual association of left-sided inferior vena cava with slow-fast atrioventricular reentrant tachycardia

We report an extremely rare association of left-sided inferior vena cava (IVC) in a 38-year-old female presenting with recurrent palpitation for the past 2 years with typical slow-fast atrioventricular reentrant tachycardia (AVNRT). We delineated the course of the left-sided IVC with pigtail injection and catheter course to the right atrium and successfully modified the slow pathway with conventional catheters with difficulty in ablation catheter maneuvering and his catheter stability was an issue. Our case is the first description of an unusual association of isolated left-sided IVC in a patient with typical AVNRT.

“Triple duodenal obstruction” complicated with intestinal malrotation and several cardiovascular malformations

Triple duodenal obstruction is an extremely rare disorder—apparently only two cases were reported in the English literature. We present a third case complicated with some cardiovascular anomalies (interrupted inferior vena cava, left-sided inferior vena cava, preduodenal portal vein, and ventricular septal defect) and intestinal malrotation. Operative procedure to reconstruct continuity of the duodenal lumen was a combination of longitudinal incision, partial web resection, and transverse closure at the first obstruction site together with diamond-shaped duodeno-duodenostomy between the oral side of the second obstruction and the anal side of the third obstruction.

Oblique Lumbar Interbody Fusion from the Right-Side Approach in the Treatment of a Patient with Left-Sided Inferior Vena Cava

Oblique lumbar interbody fusion (OLIF) can achieve better reconstruction of the lumbar spine via the anatomic corridor between the psoas muscle and the great vessels. Despite OLIF is considered as an effective and relatively safer procedure, congenital anomalies of the main vessels surrounding the oblique corridor may pose higher risk of vascular damage, which should bear in mind in deciding to use the OLIF procedure. We presented a case of an anomalous left-sided inferior vena cava (IVC) who underwent an OLIF procedure alternatively through a larger corridor between the aorta and the right psoas muscle. The lumbar sympathetic trunk (LST) could be observed and subsequently protected at the medial border of the right psoas muscle.

Laparoscopic Right Donor Nephrectomy with Complete Left Sided Inferior Vena Cava: Rare Case Report

Vascular anomalies is associated with increased complexity and complication during live donor nephrectomy. We hereby report a right transperitoneal laparoscopic nephrectomy done in donor with complete left sided IVC (LIVC). Preoperative evaluation by CT Angiography clearly demonstrated venous anomaly. In view of long right renal vein, right laparoscopic donor nephrectomy was performed. Length was sufficient for anastomosis in recipient. Recipient's serum creatinine was 1.2 mg/dl on 5th postoperative day. Postoperative stay for donor was uneventful. LIVC is not a contraindication for transperitoneal Laparoscopic donor nephrectomy.

Peripheral Arterial Disease with Small Aorta Syndrome: A Case Report.

We report a case of a 79-year-old woman who experienced difficulty in walking. Contrast-enhanced computed tomography revealed severe stenosis and calcification of the infrarenal aorta. The minimum diameter of the infrarenal aorta was 8 mm and that of the common femoral artery was 4 mm. Other vessels with abnormalities were the hypoplastic left subclavian artery and the left-sided inferior vena cava. The patient was treated with right axillobifemoral bypass. In patients with small aorta syndrome, the graft patency rate is low, and long-term follow-up is important.

Laparoscopic aortic lymphadenectomy in left-sided inferior vena cava

Transposition of the inferior vena cava (IVC), also known as left-sided IVC (LS-IVC), is a rare congenital variant which results from regression of the right supracardinal vein and persistence of...

A patient with left-sided inferior vena cava who received oblique lumbar interbody fusion surgery: a case report

BackgroundOblique lateral interbody fusion surgery has become increasingly popular for lumbar degenerative diseases. The oblique corridor is between the psoas muscle and the retroperitoneal vessels, and its use could result in decreased tissue trauma, minimal blood loss, and short operation times. Patients who undergo oblique lateral interbody fusion surgery are always placed in the right lateral position to avoid damage to the inferior vena cava, which is typically a right-sided vessel. There is a substantial risk of vascular injury during the operation if there are anatomical variations in the vessels.Case presentationA 77-year-old man, of the Han nationality, with lumbar spinal stenosis underwent stand-alone oblique lateral interbody fusion surgery. Transverse magnetic resonance imaging of the lumbar spine indicated that his inferior vena cava was left-sided. A three-dimensional reconstructed image of abdominal computed tomography angiography showed that the inferior vena cava was located on the left side. Finally, the surgeon decided to change the position of our patient from a right lateral position to a left lateral position before the surgery.ConclusionsTo date, this is the first reported case where a patient underwent oblique lateral interbody fusion surgery in a left lateral decubitus position due to a left-sided inferior vena cava. This case demonstrates that carefully reading radiological results is important for operation planning and avoiding anatomical complications.

Duplication of the inferior vena cava: evidence of a novel type IV.

Anatomical variations of the inferior vena cava, including the double inferior vena cava or isolated left inferior vena cava, are uncommon and of great clinical importance. Inferior vena cava variations signify predisposition to deep vein thrombosis and may complicate retroperitoneal surgeries including abdominal aortic surgery. Failure to recognize such variations may predispose a patient to life- threatening complications. This prospective anatomical study assessed 129 cadavers for variations of the inferior vena cava. One of the 129 cadavers (0.78%) possessed a double inferior vena cava and none (0%) possessed an isolated left inferior vena cava. The left-sided inferior vena cava was of a larger diameter than that of the right-sided inferior vena cava - opposite of what would be seen in a Type III duplication. Therefore, this observation expands the three-type classification system to include a Type IV duplication.

Ruptured Abdominal Aortic Aneurysm with a Duplicated Inferior Vena Cava.

We report a very rare case of a ruptured abdominal aortic aneurysm (AAA) with an anomaly of the inferior vena cava (IVC). The AAA was covered with a large hematoma and an expanded vein was on its left side. It was not until we could not locate the IVC on the right side of AAA that we recognized the anomaly during the operation. Although we reviewed the findings on enhanced computed tomography, we were confused whether the case was a duplicated or left-sided IVC. Subsequently, a bifurcated vascular prosthesis was implanted without ligation of the left renal vein to join the left-sided IVC.

Single Atrium- A Case Report

Single atrium is a rare congenital heart disease in which there is developmental absence of both septum primum and secondum part of atrial septum. this report of rare case is to share our experience in surgery for Single atrium. Patient with single atrium with persistant left superior venacava (PLSVC) and left sided Inferior venacava (IVC) underwent gluteryldehye treated autologous pericardial patch closure, separating the two atria and leaving the coronary sinus, both PLSVC and Left IVC in the right atrial side and drainage of all four pulmonary vein into Left atrium. Post operatively there was no conduction defects in electrocardiogram and echocardiogram showed no residual shunt across the neoatrial septum. The long-term survival of surgical correction of single atrium is good. To avoid injury to the conduction system one has to be utmost careful by keeping the sutures remote and superficial from the bundle.
 KYAMC Journal Vol. 10, No.-1, April 2019, Page 54-56

There are more anatomical variants in heaven and earth, Horatio, than are dreamt of in our philosophy: the precaval left renal artery

To describe the CT findings in eight patients with left-sided inferior vena cava (IVC) in whom the left renal artery presented a precaval course (pLRA). We searched the teaching files of six radiology departments for patients with pLRAs. Eight patients were found, and the available imaging studies and clinical histories were reviewed. Associated vascular and renal anomalies were noted. No patient had been examined for problems related to the vascular anomaly found. Four had a double IVC and two a solitary left IVC; in all, the left-sided IVCs had hemiazygos continuation. One patient had situs viscerum inversus. In one case, there was a left kidney in left iliac fossa. Although rare and probably overlooked, a pLRAs can be encountered in patients with situs viscerum inversus or presenting a left-sided IVC with hemiazygos continuation. These vessels can cause technical problems during surgery at the left renal hilum and should be specifically searched for in patients with vascular anomalies.

Right varicocele secondary to left-sided inferior vena cava with a retro-aortic left renal vein and azygos continuation.

Varicocele represents the main cause of male infertility. Right-sided varicocele is rare and can be due to renal malignancy or a venous abnormality. The most common anomaly of the inferior vena cava (IVC) is interruption of IVC with azygos continuation, which is recognized as an uncommon congenital anomaly. The prevalence of the interruption of IVC is less than 0.3% in the healthy population. We describe the case of a 26-year-old man who had right varicocele because of a right-sided IVC with a retro-aortic left renal vein and azygos continuation. The right and left IVCs received the right and left common iliac veins, respectively, and the left renal vein crossed posteriorly to the aorta and joined the right IVC. The right IVC continued cephalad as the azygos vein within the retrocrural space. Isolated right-sided varicoceles are uncommon, but practitioners should be aware of such a condition. In case of a venous anomaly, clinicians should aware of the association with other important clinical presentations.

Bilobed spleen, transposition of the inferior vena cava and Riedel lobe: an extremely rare imaging finding in the same case.

There is a wide range of congenital anomalies of the spleen regarding its shape, location, number, and size. Most of these congenital anomalies are commonly detected on ultrasonography, CT, or MRI and may sometimes represent a challenging diagnosis for radiologists and clinicians. The bilobed spleen is an extremely rare form of congenital anomaly. In most cases, it is accidentally discovered during abdominal surgeries. The bilobed spleen is usually large in size when compared with the normal spleen; hence, it is more liable to trauma. Transposition of the inferior vena cava (IVC; also known as left-sided IVC) refers to a very rare variant course of the IVC. The most common variations are duplicate IVC, as well as retroaortic left renal vein and circumaortic venous rings. Left-sided IVC occurs in 0.17–0.5% of the general population. Diagnosis of left-sided IVC is important when planning vascular procedures like portosystemic shunt, the placement of an IVC filter, nephrectomy, and renal transplant. There should be an awareness of the Riedel lobe, which is a common anatomical variant of the liver, as it can simulate a mass. Its misidentification as a pathological abdominal mass can lead to surgery; pathology can also occur (e.g. malignancy or even torsion). In this report, we presented a case of a bilobed spleen that was misdiagnosed as a left renal mass during routine abdominal ultrasonography in a 25-year-old female who complained of recurrent left hypochondrium pain. The bilobed configuration was confirmed with MRI and ultrasound examination of the abdomen.

Laparoscopic-assisted Surgery for Colon Cancer in a Patient with a Left-sided Inferior Vena Cava: A Case Report

Introduction: A left-sided Inferior vena cava (IVC) is a rare congenital vascular anomaly that is usually incidentally detected by computed tomography. We herein report a case involving a patient with a left-sided IVC who underwent laparoscopic-assisted sigmoidectomy for sigmoid colon cancer.

Abdominal Aortic Surgery in the Presence of Inferior Vena Cava Anomalies: A Case Series

Left-sided inferior vena cava (LIVC) and duplicated inferior vena cava (DIVC) are rare asymptomatic congenital abnormalities. Unrecognized, these anomalies can be the source of major injuries and cause serious life-threatening bleeding complications especially during abdominal aortic surgery. Retrospective data for patients with 2 major inferior vena cava (IVC) anomalies that underwent aortic surgery over a 13-year period were collected. Patient demographics, type of aortic disease and caval anomaly, surgical approach, type of aortic reconstruction associated with procedure on caval vein, postoperative complications, and in-hospital mortality were recorded. There were 9 patients with inferior vena cava (IVC) anomalies who underwent aortic surgery. All of them were men, with a median age of 66.2years. Seven had an LIVC and 2 had DIVC. Five patients were operated on due to abdominal aortic aneurysm and 4 due to aortoiliac occlusive disease. In all patients, a midline transperitoneal aortic approach was performed. In 5 cases, the left IVC had to be temporarily resected and later reconstructed, and in the other 4 it was just mobilized. There were no postoperative complications except in one patient who developed deep vein thrombosis in the left calf; this was successfully treated with anticoagulant therapy. Due to favorable results and low incidence of perioperative complications and in the absence of other associated abdominal pathology, we propose the midline transperitoneal approach with mobilization or temporary resection of LIVC.