Prenatal diagnosis and clinical outcomes of isolated interruption of the inferior vena cava: an analysis of 12 cases

Abstract

Objectives: This study aimed to comprehensively investigate the clinical manifestations and outcomes of prenatally diagnosed isolated interrupted inferior vena cava (IIVC) with azygos continuation to shed light on the significance of prenatal diagnosis. Methods: A longitudinal study involved 12 fetuses prenatally diagnosed with IIVC and azygos continuation. Detailed fetal anomaly scans and echocardiography were performed, and pediatric cardiologists confirmed postnatal diagnoses. Genetic testing and extensive follow-ups were also performed. Results: The study confirmed the high diagnostic accuracy of prenatal identification, with 100% postnatal confirmation. Most patients exhibited favorable outcomes, emphasizing the importance of prenatal diagnosis. Genetic testing revealed normal chromosomal arrangements in all tested cases. Conclusion: Our study underscores the vital role of prenatal diagnosis in managing isolated IIVC cases and highlights their generally favorable prognosis. This study contributes to understanding this rare vascular anomaly and its implications for clinical practice.

Keywords

• Isolated interruption inferior vena cava
• azygos continuation
• prenatal diagnosis
• echocardiography.

İzole inferior vena cava kesintisinin prenatal tanısı ve klinik sonuçları: 12 vaka analizi

Abstract

Amaç: Bu çalışmanın amacı, izole inferior vena cava kesintisi (IIVC) vakalarını prenatal olarak tanılamak ve yönetmek için prenatal tanının önemini ve genellikle olumlu bir prognoza sahip olduğunu vurgulamaktı. Yöntem: Bu çalışma, IIVC ile azygos devamı prenatal olarak tanı alan 12 fetusu içeren bir uzunlamasına çalışma tasarımını takip etti.. Ekokardiyografi ve sonografi değerlendirmeleri, fetal kalp görüntülemesi konusunda uzmanlaşmış perinatoloji ve kardiyoloji uzmanları tarafından gerçekleştirildi. Bulgular: Bu çalışma, IIVC tanısı alan 12 fetusun prenatal olarak tanılandığını ve bu tanıların pediatrik kardiyologlar tarafından doğrulandığını gösterdi. Klinik sonuçlar genellikle olumlu oldu. Sonuç: Bulgular, prenatal tanının IIVC vakalarını güvenilir bir şekilde tanılayabileceğini ve bu nadir vasküler anormalliğin genellikle olumlu bir prognoza sahip olduğunu vurguladı. Bu çalışma, IIVC'nin doğru bir şekilde yönetilmesinin önemini ve prenatal tanının yaşamın ileri dönemlerindeki klinik sonuçları etkileyebileceğini vurgulamaktadır.

Keywords

• Vena kava inferiorda izole kesinti
• azigos devamı
• prenatal tanı
• ekokardiyografi.

References

1. Giang DTC, Rajeesh G, Vaidyanathan B. Prenatal diagnosis of isolated interrupted inferior vena cava with azygos continuation to superior vena cava. Ann Pediatr Cardiol. 2014;7:49-51.
2. Bass JE, Redwine MD, Kramer LA, Huynh PT, Harris JHJ. Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings. Radiographics. 2000;20(3):639-652.
3. Celentano C, Malinger G, Rotmensch S, Gerboni S, Wolman Y, Glezerman M. Prenatal diagnosis of interrupted inferior vena cava as an isolated finding: a benign vascular malformation. Ultrasound Obstet Gynecol. 1999;14(3):215-218.
4. Tubau A, Grau J, Filgueira A, et al. Prenatal and postnatal imaging in isolated interruption of the inferior vena cava with azygos continuation. Prenat Diagn. 2006;26:872-874.
5. Bronshtein M, Khatib N, Blumenfeld Z. Prenatal diagnosis and outcome of isolated interrupted inferior vena cava. Am J Obstet Gynecol. 2010;202(4):398.e1-4.
6. Shahrouki P, Lee EW, Ruehm S. Polysplenia syndrome and sickle cell trait: extensive deep venous thrombosis from venous stasis and hypercoagulability. Clin Imaging. 2022;82:127-131.
7. Xu Q, Sun HX, Xie JS, Wang JL, Pei QY, Zhang XH. Characteristics and prognosis of interrupted inferior vena cava with azygous continuation. Zhonghua Fu Chan Ke Za Zhi. 2018;53(3):149-154.
8. Vijayaraghavan SB, Raja V, Chitra T V. Interrupted inferior vena cava and left-sided subrenal inferior vena cava: prenatal diagnosis. J Ultrasound Med. 2003;22(7):747-752.

9. Moradi B, Moosavi NS, Kazemi MA, Tahmasebpour AR, Fattahi Masrour F. A case of prenatally detected left isomerism and hemiazygos continuation of inferior vena cava. J Clin Ultrasound. 2017;45(7):430-433.
10. Sheley RC, Nyberg DA, Kapur R. Azygous continuation of the interrupted inferior vena cava: a clue to prenatal diagnosis of the cardiosplenic syndromes. J Ultrasound Med. 1995;14(5):381-387.
11. Babaoğlu K, Doğan Y, Başar EZ, Usta E. Prenatal diagnosis of hepatic interruption of the inferior vena cava with azygos/hemiazygos continuation without structural heart defects: a case series. J Clin Ultrasound. 2022;50(6):795-802.
12. Effler DB, Greer AE, Sifers EC. Anomaly of the vena cava inferior; report of fatality after ligation. JAMA. 1951;146(14):1321-1322.
13. Mandato Y, Pecoraro C, Gagliardi G, Tecame M. Azygos and hemiazygos continuation: an occasional finding in emergency department. Radiol Case Rep. 2019;14(9):1063-1068.
14. Lambert M, Marboeuf P, Midulla M, et al. Inferior vena cava agenesis and deep vein thrombosis: 10 patients and review of the literature. Vasc Med. 2010;15(6):451-459.
15. Kwan KJ, Li H-L, Chan YC, Huang J-X, Cui D-Z, Cheng SW. Venous thromboembolism in a patient with ınterrupted ınferior vena cava and compressed azygos continuation: a case report and review of literature. Vasc Endovascular Surg. 2023;57(6):643-649.
16. Pasqui E, de Donato G, Camarri S, et al. Case report: inferior vena cava agenesia in a young male patient presenting with bilateral iliac veins thrombosis. Front Surg. 2022;9:832336.
17. Thomas SD, Ofri A, Tang T, Englund R. Endovascular reconstruction of an interrupted inferior vena cava. Int J Surg Case Rep. 2014;5(2):59-62.
18. Raymundo SRO, Cabral VS, Cavalieri RF, Reis Neto F. Thrombolysis for deep venous thrombosis associated with inferior vena cava agenesis in a young patient. BMJ Case Rep. 2019;12(5):e229840.
19. Sagban TA, Grotemeyer D, Balzer KM, et al. Surgical treatment for agenesis of the vena cava: a single-centre experience in 15 cases. Eur J Vasc Endovasc Surg. 2010;40(2):241-245.
20. Parsa P, Lane JS 3rd, Barleben AR, Owens EL, Bandyk D. Congenital agenesis of inferior vena cava: a rare cause of unprovoked deep venous thrombosis. Ann Vasc Surg. 2015;29(5).