Fagouri Jihane, Ben El Makki Abdelilah, Outahyou Amina, El Ghiati Hanaa, Lahmouz Youssef, Bennani Meryem, El Azzouzi Rania, Ez-Zaky Sara, Saouab Rachida, Kheyi Jamal, Bouzelmat Hicham, Benyass Aatif, Chaib Ali
Rhythmology Department, Mohamed V Military Training Hospital, Rabat, Morocco.
Radiology Department, Mohamed V Military Training Hospital, Rabat, Morocco.
Radiol Case Rep. 2024 Aug 21;19(11):5094-5099. doi: 10.1016/j.radcr.2024.07.114. eCollection 2024 Nov.
Inferior vena cava IVC is a crucial route for catheter access (both directly to the right heart and indirectly through a transeptal puncture to the left heart, used in most electrophysiological procedures). However, interrupted IVC is a real challenge to traditional arrythmia ablation approaches, compromising in certain cases the success of the procedure. A well-developed azygos continuation offers an alternative pathway, bypassing the interrupted segment of the IVC. We report the case of a 60 years old female, who underwent catheter ablation of a counterclockwise flutter. During the procedure, she was discovered to have an uncommon anatomical venous pathway from femoral access to the right heart chambers. She was diagnosed to have an interruption of the supra-renal segment of the inferior vena cava with azygos continuation. Radiofrequency ablation of the cavotricuspid isthmus was successfully performed through the azygos continuation.
下腔静脉（IVC）是导管进入的关键路径（既可以直接进入右心，也可以通过经房间隔穿刺间接进入左心，这在大多数电生理手术中都会用到）。然而，下腔静脉中断对传统的心律失常消融方法来说是一个真正的挑战，在某些情况下会影响手术的成功率。发育良好的奇静脉延续提供了一条替代途径，绕过了下腔静脉的中断段。我们报告了一例60岁女性患者，她接受了逆时针房扑的导管消融术。在手术过程中，发现她有一条从股静脉进入到右心腔的罕见解剖学静脉通路。她被诊断为下腔静脉肾上段中断并奇静脉延续。通过奇静脉延续成功地进行了腔静脉三尖瓣峡部的射频消融。
