TY - JOUR T1 - Tetralogy of Fallot, Absent Vena Cava Superior, Persistent Left Vena Cava Superior, and Interrupted Vena Cava Inferior: A Case of Struggle in Open Heart Surgery TT - Fallot Tetralojisi, Vena Cava Süperior Yokluğu, Persistan Sol Vena Cava Süperior ve Kesintili Vena Cava İnferior: Açık Kalp Cerrahisindeki Güçlük Üzerine Bir Olgu AU - İştar, Hande AU - Harmandar, Buğra PY - 2025 DA - April Y2 - 2025 DO - 10.18678/dtfd.1580769 JF - Duzce Medical Journal JO - Duzce Med J PB - Duzce University WT - DergiPark SN - 1307-671X SP - 102 EP - 104 VL - 27 IS - 1 LA - en AB - Interruption of vena cava inferior (VCI) is extremely rare, in occurrence in isolation or association with asplenia or polysplenia syndromes. In this abnormality, the infrahepatic segment of the VCI is absent, by representing the inadequacy of fusion of subcardinal embryological parts of the VCI. It is compensated by an azygos or hemiazygos vein that continues on the posterior wall of the thoracic cavity. In this case report, a case of incidentally diagnosed interrupted VCI in a patient diagnosed with tetralogy of Fallot (TOF), major aortopulmonary collateral artery (MAPCA), right arcus aorta, absence of right vena cava superior (VCS), and persistent left vena cava superior (PLVCS), and its successful surgical treatment was presented. If the hepatic vein confluence is of adequate size, the cannulation for cardiopulmonary bypass circuit through the hepatic vein confluence is safe in case of interrupted VCI. KW - Superior vena cava KW - inferior vena cava KW - persistent left vena cava superior KW - tetralogy of Fallot N2 - Kesintili vena kava inferior (vena cava inferior, VCI), izole olarak ya da aspleni veya polispleni sendromlarıyla birlikte meydana gelmesiyle, oldukça nadir olarak görülür. Bu anomalide, vitellin ve subkardinal embriyolojik VCI’nın füzyonundaki yetersizlik nedeniyle, VCI’nın infrahepatik segmenti gelişmemiştir. Bu durum, torasik boşluğun posterior duvarında devam eden azygos ya da hemiazygos veni tarafından kompanze edilir. Bu olgu sunumunda, Fallot tetralojisi (tetralogy of Fallot, TOF), majör aortikpulmoner kollateral arter (major aortopulmonary collateral artery, MAPCA), sağ arkus aorta, sağ vena kava süperior (vena cava superior, VCS) yokluğu ve persistan sol vena kava süperior (persistent left vena cava superior, PLVCS) tanısı olan bir hastada tesadüfen teşhis edilen kesintili VCI vakası ve başarılı cerrahi tedavisi sunulmuştur. Hepatik ven konflüensi yeterli büyüklükteyse, kesintili VCI durumunda hepatik ven konflüensinden açık kalp cerrahisi dolaşımı için kanülasyon güvenlidir. CR - Zafar SI, Halim A, Khalid W, Shafique M, Nasir H. Two cases of interrupted inferior vena cava with azygos / hemiazygos continuation. J Coll Physicians Surg Pak. 2022;32(8):S101-3. CR - Bista B, Ferris J, Na N, Krishnam M, Urgun D. Unilateral absence of pulmonary artery and azygous continuation of interrupted inferior vena cava. Radiol Case Rep. 2020;15(6):688-90. CR - Bansal N, Ghosh R, Sankhyan LK, Chatterjee S, Chatterjee S, Bose S. Left isomerism with bilateral superior vena cava, interrupted inferior vena cava and tetralogy of Fallot. Ann Pediatr Cardiol. 2020;13(4):364-7. CR - Chen SJ, Wu MH, Wang JK. Clinical implications of congenital interruption of inferior vena cava. J Formos Med Assoc. 2022;121(10):1938-44. CR - Abu-Hilal LH, Barghouthi DI, AbuKeshek T, Tamimi H, Khatib H, Dayeh AH. Interrupted inferior vena cava syndrome discovered incidentally after minimally invasive mitral valve repair in a 31-year-old female patient: A case report. Int J Surg Case Rep. 2023;109:108621. CR - Pillai JB, Kpodonu J, Yu C, Borger MA. Heterotaxy syndrome with azygous continuation-causing pseudo Budd-Chiari syndrome after cardiopulmonary bypass. Ann Thorac Surg. 2006;81(5):1890-2. CR - Kawashima Y, Kitamura S, Matsuda H, Shimazaki Y, Nakano S, Hirose H. Total cavopulmonary shunt operation in complex cardiac anomalies: A new operation. J Thorac Cardiovasc Surg. 1984;87(1):74-81. CR - Shah TR, Hiremath CS, Diwakar A, Soman Rema KM. Absent superior vena cava in tetralogy of Fallot. Ann Card Anaesth. 2018;21(2):205-7. CR - Cheung CKM, Law MF, Wong KT, Tam MTK, Chow KM. Massive pulmonary embolism in a patient with polysplenia syndrome and interrupted inferior vena cava with azygous continuation. Arch Med Sci. 2018;14(1):251-3. CR - Koc Z, Oguzkurt L. Interruption or congenital stenosis of the inferior vena cava: prevalence, imaging, and clinical findings. Eur J Radiol. 2007;62(2):257-66. UR - https://doi.org/10.18678/dtfd.1580769 L1 - https://dergipark.org.tr/en/download/article-file/4346088 ER -