Leadless pacemaker implantation and azygos continuation in the inferior vena cava: a case description

[摘要] Azygos continuation (AC) of the inferior vena cava (IVC),also known as the absence of the hepatic segment of theIVC with AC, is a rare anatomic variant in the generalpopulation with an incidence of 0.6% (1). AC of the IVCis congenital and independent from other anatomicalvariants. It is primarily caused by the absence or hypoplasiaof the IVC’s hepatic segment. The IVC below the hepaticsegments flows upward through the azygos into the superiorvena cava (SVC) and eventually drains into the right atrium.The renal portion of the IVC receives blood flow fromthe kidneys and lower extremities and drains into the SVCthrough the azygos vein. The azygos vein, azygos arch, andSVC dilate to accommodate the increase in blood flow (2).Usually, AC in the IVC is asymptomatic and does not affectthe functionality of the cardiovascular system. However, itsignificantly impacts leadless pacemaker (LP) implantationvia the femoral vein. The LP is a feasible alternative tothe single-ventricle pacemaker; that is, a pacemaker thatsimply paces the ventricle but not the atrium.

[学科分类] 外科医学