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Incidental finding of interrupted inferior venacava during minimally invasive cardiac surgery


1 Department of Cardiac Anaesthesia, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
2 Department of Cardiothoracic and Vascular Surgery, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
3 Department of Interventional Radiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India

Correspondence Address:
Subash Sundar Singh
Department of Cardiac Anaesthesia, Kerala Institute of Medical Sciences, P.B No: 1, Anayara, Trivandrum - 695 029, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_170_19

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Year : 2021  |  Volume : 24  |  Issue : 2  |  Page : 234-237

 

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We report a case of 44-year-old female patient with congenital heart disease, ostium secundum atrial septal defect (ASD) with moderate mitral regurgitation for minimally invasive ASD repair along with mitral valve repair. Venous cannulations were performed through right internal jugular vein and right femoral vein (RFV) and arterial cannulation was accomplished through right femoral artery. Intraoperative transesophageal echocardiography (TEE) could not visualize venous cannula through RFV. However, cardiopulmonary bypass (CPB) was initiated and surgery was proceeded. During surgery, patients abdomen became tense and distened, ontable ultrasound examination of abdomen was done after completion of the surgery to rule out hemoperitoneum but was inconclusive, patient was evaluated further under fluoroscopy in cathlab and found to have interrupted inferior vena cava. Postoperative course of the patient was uneventful. We discuss the importance of preoperative evaluation and the role of TEE in placement of cannulas during minimally invasive cardiac surgery.






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1 Department of Cardiac Anaesthesia, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
2 Department of Cardiothoracic and Vascular Surgery, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
3 Department of Interventional Radiology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India

Correspondence Address:
Subash Sundar Singh
Department of Cardiac Anaesthesia, Kerala Institute of Medical Sciences, P.B No: 1, Anayara, Trivandrum - 695 029, Kerala
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_170_19

Rights and Permissions

We report a case of 44-year-old female patient with congenital heart disease, ostium secundum atrial septal defect (ASD) with moderate mitral regurgitation for minimally invasive ASD repair along with mitral valve repair. Venous cannulations were performed through right internal jugular vein and right femoral vein (RFV) and arterial cannulation was accomplished through right femoral artery. Intraoperative transesophageal echocardiography (TEE) could not visualize venous cannula through RFV. However, cardiopulmonary bypass (CPB) was initiated and surgery was proceeded. During surgery, patients abdomen became tense and distened, ontable ultrasound examination of abdomen was done after completion of the surgery to rule out hemoperitoneum but was inconclusive, patient was evaluated further under fluoroscopy in cathlab and found to have interrupted inferior vena cava. Postoperative course of the patient was uneventful. We discuss the importance of preoperative evaluation and the role of TEE in placement of cannulas during minimally invasive cardiac surgery.






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