Abu-Hilal Lila H, Barghouthi Duha I, AbuKeshek Tawfiq, Tamimi Helmi, Khatib Hassan, Dayeh Abdul-Hakim
Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Int J Surg Case Rep. 2023 Aug;109:108621. doi: 10.1016/j.ijscr.2023.108621. Epub 2023 Aug 4.
Femoral cannulation is a technique used in minimally invasive cardiac surgery (MICS) for accessing the heart through the femoral artery and vein. However, the presence of an interruption in the inferior vena cava (IVC) can pose challenges during the procedure. Understanding the patient's venous anatomy is crucial to ensure successful cannulation.
We present the case of a 31-year-old female patient scheduled for minimally invasive mitral valve repair. During the procedure, femoral vein cannulation was unsuccessful. Subsequent diagnostic Computed Tomography (CT) revealed an interrupted IVC with azygos continuation.
The interruption of the IVC can make cannulation through the femoral vein difficult or impossible due to the absence of the femoral vein or the presence of a collateral, necessitating alternative approaches. Preoperative imaging, such as CT, plays a significant role in identifying IVC interruptions and guiding surgical planning.
Our case highlights the challenges associated with IVC interruptions during femoral cannulation in MICS. Preoperative imaging is essential for identifying anatomical variations and determining the most appropriate cannulation approach.
股动静脉插管是一种用于微创心脏手术（MICS）的技术，通过股动脉和静脉进入心脏。然而，下腔静脉（IVC）中断的存在可能会在手术过程中带来挑战。了解患者的静脉解剖结构对于确保插管成功至关重要。
我们介绍了一名31岁女性患者的病例，该患者计划进行微创二尖瓣修复术。在手术过程中，股静脉插管未成功。随后的诊断性计算机断层扫描（CT）显示下腔静脉中断并由奇静脉延续。
由于股静脉缺失或存在侧支循环，下腔静脉中断会使通过股静脉插管变得困难或无法进行，因此需要采用替代方法。术前成像，如CT，在识别下腔静脉中断和指导手术规划方面起着重要作用。
我们的病例突出了微创心脏手术中股动静脉插管时与下腔静脉中断相关的挑战。术前成像对于识别解剖变异和确定最合适的插管方法至关重要。
