Wu WK, Guth CM, Mulherin JL. Abdominal Aortic Aneurysm Repair Requiring Left-Sided Inferior Vena Cava Interposition.
Ann Vasc Surg 2020;
68:573.e5-573.e7. [PMID:
32439518 DOI:
10.1016/j.avsg.2020.05.013]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 05/02/2020] [Accepted: 05/05/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND
Left-sided inferior vena cava (IVC) is a rare congenital venous anomaly. We describe a case of open repair of a nonruptured abdominal aortic aneurysm (AAA) in a patient with left-sided inferior vena cava requiring IVC transection and reconstruction with interposition graft.
CASE REPORT
A 56-year-old man presented for elective repair of a 6.2-cm AAA with preoperative imaging demonstrating a left-sided IVC. Intraoperatively, IVC crossing at the aneurysm neck conferred inadequate exposure for arterial anastomosis. After transection of the IVC, the AAA was repaired, and the IVC was reconstructed with a 24-mm Dacron tube graft. His recovery was uneventful, and grafts were patent at 3-month follow-up.
CONCLUSIONS
Left-sided IVC is a rare anomaly encountered during abdominal aortic surgery that presents technical challenges. Division of the IVC and reconstruction with interposition graft is a possible solution if other techniques fail to provide adequate exposure.
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