Artery or Vein? A Classic Example of a Pulsatile Inferior Vena Cava in a Patient with Severe Tricuspid Regurgitation.
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ABSTRACT:
SUBMITTER: Patel KD
PROVIDER: S-EPMC6058243 | biostudies-other | 2017 Jun
REPOSITORIES: biostudies-other
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Project description:Intravenous lipoma of the inferior vena cava is an incidental finding on contrast-enhanced computed tomography in 0.5% of individuals. We report a case of multiple intravenous lipomas discovered during diagnosis of cholangitis in a 39-year-old woman. Imaging revealed three fatty masses that appeared connected by cordlike structures: one in the left renal vein with wide mural attachment and two in the inferior vena cava, the higher of which was mobile. We hypothesize that these originated as a single lipoma that subsequently divided into three distinct masses. Because mobile masses may cause pulmonary thromboembolism, surgery is recommended in these cases.
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Project description:Congenital saccular aneurysms of the inferior vena cava (IVC) are extremely rare, with 23 cases reported so far. We present a case of a 55-year-old woman with an acute episode of back pain that mimicked aortic dissection. Computed tomography ruled out aortic dissection but demonstrated a saccular aneurysm of the infrarenal IVC and a circumaortic left renal vein. The saccular aneurysm was excised, and the postoperative anatomopathologic examination revealed that it was congenital in nature. Surprisingly, preoperative symptoms of recurrent palpitations, dyspnea, and positional abdominal discomfort resolved after resection. This is the first reported case of a symptomatic congenital saccular aneurysm of the IVC with an associated circumaortic left renal vein.
| S-EPMC8076958 | biostudies-literature
Project description:BackgroundTransseptal puncture and pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) are generally performed via the inferior vena cava (IVC). However, in cases where the IVC is inaccessible, a specific strategy may be needed.Case summaryAn 86-year-old woman with paroxysmal AF and an IVC filter in situ was referred to our hospital for ablation therapy. An IVC filter for pulmonary embolism and deep venous thrombosis had been implanted 15 years prior, therefore we selected a transoesophageal echocardiography (TOE)-guided transseptal puncture using a superior vena cava (SVC) approach. After the single transseptal puncture, we performed fast anatomical mapping, voltage mapping by multipolar mapping catheter, and then PVI by contact force-guided radiofrequency catheter using a steerable sheath. Following the ablation, bidirectional conduction block between the four pulmonary veins and the left atrium was confirmed by both radiofrequency and mapping catheter. No complications occurred and no recurrence of AF was documented in the 12 months after the procedure.DiscussionWhen performing a transseptal puncture during AF ablation, an SVC approach, via access through the right internal jugular vein, enables the sheath to directly approach the left atrium without angulation and improves operability of the ablation catheter. Combining the use of general anaesthesia, TOE, a steerable sheath, and contact force-guided ablation may contribute to achieving minimally invasive PVI with a single transseptal puncture via an SVC approach.
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Project description:Introduction Kidney and liver cysts in autosomal dominant polycystic kidney disease (ADPKD) can compress the inferior vena cava (IVC), but IVC compression prevalence and its risk factors are unknown. Methods Patients who have ADPKD (n = 216) with abdominal magnetic resonance imaging (MRI) studies and age-/sex-matched controls (n = 216) were evaluated for IVC compression as well as azygous vein diameter (a marker of collateral blood flow) and IVC aspect ratio (left-to-right dimension divided by anterior-to-posterior dimension with a value of 1 corresponding to a circular (high pressure) IVC caudal to compression. Results Severe IVC compression (?70%) was observed in 33 (15%) ADPKD subjects and mild compression (?50% to <70%) was observed in 33 (15%) subjects; whereas controls had no IVC compression (P < 0.001). Severe IVC compression was associated with larger azygous vein (4.0 ± 1.3 mm versus 2.3 ± 0.8 mm without IVC compression; P < 0.001) and a more circular IVC cross-section upstream (mean IVC aspect ratio: 1.16 ± 0.27 vs. 1.69 ± 0.67, P < 0.001), suggesting higher pressure upstream from the compression. IVC compression was associated with older age, lower estimated glomerular filtration rate (eGFR), greater height-adjusted total kidney volumes, greater height-adjusted liver volume (ht-LV), and greater liver and renal cyst fractions (P < 0.001). No subject younger than 30 years had IVC compression, but ADPKD subjects ?40 years old had 12-fold higher risk of IVC compression (95% confidence interval [CI]: 4.2–42.4), with highest predicted probability for Mayo Clinic classes 1D (59%; 95% CI: 39%–76%) and 1E (74%; 95% CI: 49%–90%) after adjustment (P < 0.001). Women with ht-LV ? 2000 ml/m had 83% (95% CI: 59%–95%) prevalence of IVC compression. Complications of IVC compression included deep vein thrombosis (DVT) and symptomatic hypotension. Conclusions IVC compression is common in ADPKD patients >40 years old, with Mayo Clinic class 1D/E, and in females with ht-LV > 2000 ml/m. Graphical abstract
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Project description:This case describes a 57-year-old morbidly obese woman with complications of a permanent Bard inferior vena cava (IVC) filter (BD Bard, Covington, Ga) placed in 2005. She complained of recurrent abdominal pain for 6 years associated with constipation, nausea, and bloating. Computed tomography venography showed an IVC filter with malposition, strut fracture, and extrusion, and a fractured strut protruded outside of the vena cava, adjacent to the distal right common iliac artery. The da Vinci Xi Surgical System (Intuitive Surgical, Sunnyvale, Calif) was used to remove the IVC filter and its displaced fractured strut. The operation time was 189 minutes, with an estimated blood loss of 200 mL. She was discharged home on postoperative day 2 with no complications. She had complete resolution of abdominal pain at her follow-up appointment.
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Project description:Emphysematous pyelonephritis (EPN) is a progressive necrotizing infection of the renal parenchyma, collecting system and perinephric tissue. A 36-year female with uncontrolled diabetes, presented with left emphysematous pyelonephritis, with air in the infra-hepatic inferior vena cava (IVC). She was hydrated, treated with intravenous antibiotics, insulin. Percutaneous nephrostomy with Double J stenting was done in modified supine position. Patient was discharged with nephrostomy. Two weeks later, flexible ureterorenoscopy was done and obstructing papillary necrosis removed. Pneumo-vena cava due to emphysematous pyelonephritis is quite rare and careful evaluation is required. Prompt intervention is life saving and obviates the need for nephrectomy.
| S-EPMC7574042 | biostudies-literature
Project description:Congenital arteriovenous fistulas involved with the abdominal aorta are very rare. Left-sided subrenal inferior vena cava (IVC) with normal connection to the heart is also rare and has not been reported prenatally. In this article, we described a fetus with aorta-porto-umbilical vein fistulas combined with a left-sided IVC.
| S-EPMC4737632 | biostudies-other
Project description:BackgroundInferior vena cava thrombosis is a rare blunt abdominal trauma complication often associated with severe liver injury. We present two cases of inferior vena cava thrombosis due to mild liver injuries.Case presentationCase 1 was a 25-year-old woman taking oral contraceptives for dysmenorrhea who was injured in a motorcycle accident. Contrast-enhanced computed tomography revealed hepatic contusion of the sixth segment. At 1 week after the accident, inferior vena cava thrombosis was detected. Case 2 was a 58-year-old man injured in a motorcycle accident. Contrast-enhanced computed tomography showed traumatic subarachnoid hemorrhage, right hemothorax, and liver injury with hepatic contusion of the sixth segment. At 1 week after the accident, inferior vena cava thrombosis was observed.ConclusionInferior vena cava thrombosis can occur following liver injury, regardless of damage severity. When there are thrombogenic factors and damage near the inferior vena cava, follow-up examinations should be carried out.
| S-EPMC8448584 | biostudies-literature