Tetralogy of Fallot, Absent Vena Cava Superior, Persistent Left Vena Cava Superior, and Interrupted Vena Cava Inferior: A Case of Struggle in Open Heart Surgery

Year 2025, Issue: Early Access

Hande İştar , Buğra Harmandar

https://doi.org/10.18678/dtfd.1580769

Abstract

Interruption of vena cava inferior (VCI) is extremely rare, in occurrence in isolation or association with asplenia or polysplenia syndromes. In this abnormality, the infrahepatic segment of the VCI is absent, by representing the inadequacy of fusion of subcardinal embryological parts of the VCI. It is compensated by an azygos or hemiazygos vein that continues on the posterior wall of the thoracic cavity. In this case report, a case of incidentally diagnosed interrupted VCI in a patient diagnosed with tetralogy of Fallot (TOF), major aortopulmonary collateral artery (MAPCA), right arcus aorta, absence of right vena cava superior (VCS), and persistent left vena cava superior (PLVCS), and its successful surgical treatment was presented. If the hepatic vein confluence is of adequate size, the cannulation for cardiopulmonary bypass circuit through the hepatic vein confluence is safe in case of interrupted VCI.

Keywords

Superior vena cava, inferior vena cava, persistent left vena cava superior, tetralogy of Fallot

Fallot Tetralojisi, Vena Cava Süperior Yokluğu, Persistan Sol Vena Cava Süperior ve Kesintili Vena Cava İnferior: Açık Kalp Cerrahisindeki Güçlük Üzerine Bir Olgu

Abstract

Kesintili vena kava inferior (vena cava inferior, VCI), izole olarak ya da aspleni veya polispleni sendromlarıyla birlikte meydana gelmesiyle, oldukça nadir olarak görülür. Bu anomalide, vitellin ve subkardinal embriyolojik VCI’nın füzyonundaki yetersizlik nedeniyle, VCI’nın infrahepatik segmenti gelişmemiştir. Bu durum, torasik boşluğun posterior duvarında devam eden azygos ya da hemiazygos veni tarafından kompanze edilir. Bu olgu sunumunda, Fallot tetralojisi (tetralogy of Fallot, TOF), majör aortikpulmoner kollateral arter (major aortopulmonary collateral artery, MAPCA), sağ arkus aorta, sağ vena kava süperior (vena cava superior, VCS) yokluğu ve persistan sol vena kava süperior (persistent left vena cava superior, PLVCS) tanısı olan bir hastada tesadüfen teşhis edilen kesintili VCI vakası ve başarılı cerrahi tedavisi sunulmuştur. Hepatik ven konflüensi yeterli büyüklükteyse, kesintili VCI durumunda hepatik ven konflüensinden açık kalp cerrahisi dolaşımı için kanülasyon güvenlidir.

Keywords

Superior vena kava, inferior vena kava, persistan sol vena kava superior, Fallot tetralojisi

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