Abdominal Aortic Surgery in the Presence of Inferior Vena Cava Anomalies: A Case Series.

Left-sided inferior vena cava (LIVC) and duplicated inferior vena cava (DIVC) are rare asymptomatic congenital abnormalities. Unrecognized, these anomalies can be the source of major injuries and cause serious life-threatening bleeding complications especially during abdominal aortic surgery. Retrospective data for patients with 2 major inferior vena cava (IVC) anomalies that underwent aortic surgery over a 13-year period were collected. Patient demographics, type of aortic disease and caval anomaly, surgical approach, type of aortic reconstruction associated with procedure on caval vein, postoperative complications, and in-hospital mortality were recorded. There were 9 patients with inferior vena cava (IVC) anomalies who underwent aortic surgery. All of them were men, with a median age of 66.2 years. Seven had an LIVC and 2 had DIVC. Five patients were operated on due to abdominal aortic aneurysm and 4 due to aortoiliac occlusive disease. In all patients, a midline transperitoneal aortic approach was performed. In 5 cases, the left IVC had to be temporarily resected and later reconstructed, and in the other 4 it was just mobilized. There were no postoperative complications except in one patient who developed deep vein thrombosis in the left calf; this was successfully treated with anticoagulant therapy. Due to favorable results and low incidence of perioperative complications and in the absence of other associated abdominal pathology, we propose the midline transperitoneal approach with mobilization or temporary resection of LIVC.

Dimic A ，Markovic M ，Cvetkovic S ，Cinara I ，Koncar I ，Davidovic L ... -  《-》

Operative management of abdominal aortic aneurysm with left-sided inferior vena cava.

Tsukamoto S ，Shindo S ，Obana M ，Negishi N ，Sezai Y ... -  《JOURNAL OF CARDIOVASCULAR SURGERY》

Abdominal aortic replacement with a left-sided inferior vena cava: transperitoneal and left retroperitoneal approaches.

Perler BA 《JOURNAL OF CARDIOVASCULAR SURGERY》

Ruptured abdominal aortic aneurysm with left-sided inferior vena cava.

We present a case of ruptured abdominal aortic aneurysm with left-sided inferior vena cava. An 82-year-old man was admitted to our hospital with a sudden onset of severe abdominal pain and loss of consciousness. Computed tomography revealed rupture of an infrarenal abdominal aortic aneurysm and a left-sided inferior vena cava. At surgery, the inferior vena cava was found to cross anteriorly over the abdominal aorta at the usual level of the renal vein. Graft replacement was successfully performed, with careful mobilization and retraction of the inferior vena cava. The patient had an uneventful postoperative course without any deterioration of renal function.

Niino T ，Unosawa S ，Shimura K 《-》

[Reconstructive surgery of the abdominal aorta in a case of left-positioned inferior vena cava. Clinical case and review of the literature].

Giuffrida GF ，Trimarchi S ，Miani S ，Lovaria A ，Giorgetti PL ，Giordanengo F ... -  《MINERVA CARDIOANGIOLOGICA》