Saito Tetsuya, Watanabe Masafumi, Kojima Toshiya, Matsumura Takayoshi, Fujita Hideo, Kiyosue Arihiro, Takahashi Masao, Takeda Norihiko, Maemura Koji, Yamashita Hiroshi, Hirata Yasunobu, Komatsu Shuhei, Ohtomo Kuni, Nagai Ryozo
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Int Heart J. 2011;52(5):327-30. doi: 10.1536/ihj.52.327.
Interrupted inferior vena cava (IVC) with azygos continuation is a rare congenital anomaly, and is frequently associated with other cardiovascular malformations and situs anomalies, such as left isomerism. These patients usually develop deep vein thrombosis (DVT), and asymptomatic patients above 60 years of age are very rare. Here we report a case of interrupted IVC which we diagnosed in a 72-year-old woman. She was admitted to our hospital suffering from heart failure and supraventricular tachycardia. Echocardiography detected secundum atrial septal defect (ASD). An abnormal paravertebral pleural line on the chest X-rays indicated the existence of venous anomaly. Anatomical images obtained by Multidetector Computed Tomography (MDCT) helped us to successfully perform right heart catheterization procedures through azygos continuation including blood sampling from pulmonary veins. Even in elderly patients, a careful examination of chest X-rays can indicate undiagnosed venous anomalies; thus, it is critically important before planning surgical or interventional procedures.
下腔静脉中断伴奇静脉延续是一种罕见的先天性异常，常与其他心血管畸形和内脏反位异常相关，如左位异构。这些患者通常会发生深静脉血栓形成（DVT），60岁以上无症状患者非常罕见。在此，我们报告一例在一名72岁女性中诊断出的下腔静脉中断病例。她因心力衰竭和室上性心动过速入院。超声心动图检测到继发孔房间隔缺损（ASD）。胸部X线片上异常的椎旁胸膜线提示存在静脉异常。通过多排螺旋计算机断层扫描（MDCT）获得的解剖图像帮助我们成功地通过奇静脉延续进行了右心导管检查程序，包括从肺静脉采血。即使在老年患者中，仔细检查胸部X线片也可提示未被诊断的静脉异常；因此，在计划手术或介入程序之前至关重要。
