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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 2001 April;42(2):249-55

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Left-sided inferior vena cava in patients submitted to aorto iliac surgery. Our experience and review of the literature

Rispoli P., Conforti M., Cassatella R., Varetto G., Melloni C. D., Raso A. M.

From the Depart­ment of ­Medico-Sur­gical Dis­ci­plines Unit of Vas­cular Sur­gery Postgrad­uate ­School of Vas­cular Sur­gery Uni­ver­sity of ­Turin, Mol­in­ette Hos­pital, ­Turin, ­Italy


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We ­present two ­cases of ­left ­sided infe­rior ­vena ­cava, one unex­pect­edly ­observed ­during an oper­a­tion of ­aorto bife­moral ­bypass in a ­patient ­with ­severe ­Leriche syn­drome and ­almost com­plete obstruc­tion of the infra­renal ­aorta, the ­second in a ­patient ­with an aneu­rysm of the abdom­inal ­aorta, in ­whom the ­anomaly was rec­og­nized ­before the oper­a­tion. ­This ­very ­rare con­gen­ital mal­for­ma­tion (0.2-0.5%) was not rec­og­nized in the ­first ­patient by the ­duplex ­scanner per­formed pre­op­er­a­tively, prob­ably ­because of the low ­level of sus­pi­cion car­ried on by an expe­ri­enced oper­ator. Com­puter tomog­raphy angio­graphy or mag­netic res­o­nance angio­graphy, ­which ­would ­have ­surely ­shown us the ­anomaly, ­were not ­done in the ­first ­patient ­because, in the ­lack of an aneu­rysmal dis­ease or ­other abdom­inal path­o­log­ical sit­u­a­tions, ­these inves­ti­ga­tions ­were not ­required ­before oper­a­tion. The pos­sible haz­ards of ­such an unrec­og­nized mal­for­ma­tion are ­great, ­mostly in ­terms of incon­trol­lable intra­op­er­a­tive hem­or­rhages, but the ­final out­come of ­this ­case was pos­i­tive.

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