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Anomalies of the inferior vena cava vein (IVC) occur in 0.4 to 4.0% of the population. The most frequent anomalies are duplication of the inferior vena cava, as well as a left superior vena cava. Duplication of the inferior vena cava is caused specifically by the persistence of the left supracardinal vein. We present herein the case of deep venous thrombosis (DVT) associated to a double inferior vena cava with thrombosis of the right inferior vena cava and an in transit thrombus in the left vena cava arising from the left iliac vein, as well as bilateral pulmonary embolism. The decision to implant two filters or only one suprarenally, as well as the best approach, is a matter of discussion in the literature. Case report Woman, 25-year-old, with a history of oral anticonceptives use and large effort dyspnea of 3 years of evolution. Five days before her admittance to the hospital she presented deterioration of her functional class with dyspnea of mid effort, oppressive thoracic pain, and diaphoresis. Physical examination revealed a second intense cardiac sound of pulmonary focus. The echocardiogram showed dilation of the right ventricle (42 mm) with systolic pulmonary pressure calculated at 85 mmHg and a normal size left ventricle with an ejection fraction of 60%. A computed axial tomography (CAT) scan of the thorax and abdomen revealed the following: thrombi in the left main branch of the pulmonary artery, interlobar branches, lingula, and arteries of the superior lobe. In the right branch, thrombi in the bifurcation of the interlobar arteries and of the mid lobule, extending to the segmental arteries. We found a double system of infrarenal IVC, as well as thrombosis of the left common iliac vein reaching the ipsilateral common femoral vein.

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2010-10-07   |   3,717 visitas   |   Evalua este artículo 0 valoraciones

Vol. 62 Núm.3. Mayo-Junio 2010 Pags. 279-280 Rev Invest Clin 2010; 62(3-ENGLISH)