Author + information
- Received November 24, 2009
- Accepted December 16, 2009
- Published online November 16, 2010.
A 70-year-old man presented for typical atrial flutter ablation. Right femoral venous access was obtained but there was difficulty in catheter advancement into the right atrium and the procedure was abandoned. The patient was sent for a cardiac computed tomographic angiography. The images showed that the patient has azygous continuation of the inferior vena cava (IVC) that runs adjacent to the aorta (A and B)and merges with the superior vena cava (SVC) at the level of the aortic arch (C). The incidence of such an anomaly in the general population is <0.3%. Recognition of this unusual anomaly is important as it can pose technical challenges during invasive procedures. The dilated azygos vein may be misinterpreted as a paracardiac or mediastinal mass on chest radiography. This anomaly is associated with recurrent deep venous thrombosis of lower extremities, sick sinus syndrome, and atrial flutter.
- Received November 24, 2009.
- Accepted December 16, 2009.
- American College of Cardiology Foundation