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  • Title: Abdominal Aortic Aneurysm Repair Requiring Left-Sided Inferior Vena Cava Interposition.
    Author: Wu WK, Guth CM, Mulherin JL.
    Journal: Ann Vasc Surg; 2020 Oct; 68():573.e5-573.e7. PubMed ID: 32439518.
    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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