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      Prenatal diagnosis of isolated interrupted inferior vena cava with azygos continuation to superior vena cava

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          Abstract

          Absence of inferior vena cava is an uncommon congenital abnormality. It is usually associated with other structural anomalies, typically left isomerism. We report a case of interrupted inferior vena cava with azygos continuation diagnosed as an isolated finding during routine prenatal ultrasound scan, confirmed by post-natal echocardiography. Detailed ultrasound examination of the fetal anatomy failed to demonstrate other anomalies. The neonatal course of this fetus was uneventful.

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          Most cited references17

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          Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings.

          Congenital anomalies of the inferior vena cava (IVC) and its tributaries have become more commonly recognized in asymptomatic patients. The embryogenesis of the IVC is a complex process involving the formation of several anastomoses between three paired embryonic veins. The result is numerous variations in the basic venous plan of the abdomen and pelvis. A left IVC typically ends at the left renal vein, which crosses anterior to the aorta to form a normal right-sided prerenal IVC. In double IVC, the left IVC typically ends at the left renal vein, which crosses anterior to the aorta to join the right IVC. In azygos continuation of the IVC, the prerenal IVC passes posterior to the diaphragmatic crura to enter the thorax as the azygos vein. In circumaortic left renal vein, one left renal vein crosses anterior to the aorta and another crosses posterior to the aorta. In retroaortic left renal vein, the left renal vein passes posterior to the aorta. In circumcaval ureter, the proximal ureter courses posterior to the IVC. Other anomalies include absence of the infrarenal IVC or the entire IVC. These anomalies can have significant clinical implications. Awareness of these anomalies is necessary to avoid diagnostic pitfalls.
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            Inferior vena cava agenesis and deep vein thrombosis: 10 patients and review of the literature.

            Inferior vena cava agenesis (IVCA) is a rare condition, found in almost 5% of patients under 30 years old with unprovoked deep venous thrombosis (DVT). We describe 10 consecutive patients with IVCA-associated DVT and conducted an extensive literature review to investigate the typical spectrum of IVCA-associated DVT. Among our patients (eight men and two women; mean age, 25 ± 4.5 years), DVT followed intense and unusual (major) physical activity for eight of them. DVT was bilateral in six patients and unilateral in four. Ultrasonography was unable to detect IVCA, which was visualized by computed-tomography scans for seven patients, and magnetic resonance imaging and angiography for 10. Hereditary thrombophilia screening, to detect factor V Leiden or prothrombin gene heterozygosity (G20210A mutation), was positive for only two patients. Wearing elastic stockings and taking an indefinite or long-term vitamin K antagonist were prescribed for all 10 patients and nine complied with the latter. To date, 62 patients with IVCA-associated DVT have been reported in the English literature. Analysis of them and our patients yielded a typical spectrum of IVCA-associated DVT characteristics: IVCA occurs in young adults, particularly males, and is revealed by proximal DVT following major physical exertion. All were treated with a prolonged vitamin K antagonist and advised to wear elastic stockings. No precise duration of anticoagulation has been established.
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              Anomalous inferior vena cava with azygos continuation (infrahepatic interruption of the inferior vena cava). Report of 15 new cases.

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                Author and article information

                Journal
                Ann Pediatr Cardiol
                Ann Pediatr Cardiol
                APC
                Annals of Pediatric Cardiology
                Medknow Publications & Media Pvt Ltd (India )
                0974-2069
                0974-5149
                Jan-Apr 2014
                : 7
                : 1
                : 49-51
                Affiliations
                [1]Fetal Cardiology Unit, Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India
                Author notes
                Address for correspondence: Dr. Balu Vaidyanathan, Clinical Professor, Pediatric Cardiology, Amrita Institute of Medical Science, Kochi, Kerala, India. E-mail: baluvaidyanathan@ 123456gmail.com
                Article
                APC-7-49
                10.4103/0974-2069.126558
                3959062
                24701087
                32530eb4-aa55-49e5-8c9f-b244227fda96
                Copyright: © Annals of Pediatric Cardiology

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Case Report

                Cardiovascular Medicine
                azygos continuation,fetal diagnosis,interrupted inferior vena cava
                Cardiovascular Medicine
                azygos continuation, fetal diagnosis, interrupted inferior vena cava

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