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Updated: Jun 23, 2026

Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava
Published on: January 13, 2023
Is interrupted inferior vena cava a risk factor in cases of bilateral bidirectional Glenn?
Sameh Ibrahim Sersar1, Ahmed A Jamjoom
1Division of Cardiothoracic Surgery, Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. Sameh001@yahoo.com
Insights
Bilateral superior vena cavae (SVCs) increase the risk of interrupted inferior vena cava (IIVC) in single-ventricle patients. Identifying IIVC is crucial for managing children undergoing bilateral cavopulmonary anastomoses (CPAs).
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Vascular Surgery
Background:
- Bilateral superior vena cavae (SVCs) present surgical challenges in single-ventricle palliation.
- Bilateral SVCs have been associated with poorer outcomes in pediatric cardiac surgery.
Purpose of the Study:
- To investigate the association between bilateral SVCs and interrupted inferior vena cava (IIVC).
- To evaluate the outcomes of children with bilateral SVCs undergoing bilateral cavopulmonary anastomoses (CPAs).
Main Methods:
- Retrospective review of 40 children who underwent bilateral CPAs.
- Analysis of patient demographics, cardiac morphology, and presence of IIVC.
Main Results:
- Interrupted inferior vena cava (IIVC) was identified in 8 of 40 patients.
- All IIVC cases were associated with a hypoplastic right ventricle.
- Bilateral SVCs were more frequently associated with IIVC compared to single SVC.
Conclusions:
- Bilateral SVCs in single-ventricle anatomy are often linked to IIVC.
- Patients with bilateral CPAs and IIVC experience a challenging postoperative period.
- Screening for IIVC is recommended in patients with bilateral SVCs prior to or during surgical planning.
Introduction:
Bilateral superior vena cava-to-pulmonary artery anastomoses are technically challenging. Bilateral superior vena cavae (SVCs) have been thought to be a risk factor for poor outcome in children needing single-ventricle palliation.
Methods:
The files of forty children who underwent bilateral cavopulmonary anastomoses (CPAs) were reviewed.
Results:
Forty patients (31 male, 9 female) had bilateral bidirectional Glenn shunts in King Faisal Specialist Hospital and Research Center, Jeddah, in 7 years. Interrupted inferior vena cava (IIVC) was present in 8 patients. All IIVC cases featured a hypoplastic right ventricle. Twenty-four patients had a hypoplastic right ventricular morphology, and 16 patients had a hypoplastic left ventricular morphology.
Conclusions:
In single-ventricle anatomy, cases of a bilateral SVC are more often associated with an IIVC than a single SVC. Patients who undergo bilateral CPAs with an IIVC have a difficult early postoperative course. We should look for IIVC and either exclude or prove IIVC in cases of bilateral SVCs. Postoperative anticoagulation therapy in children with bilateral CPAs is important but should be investigated further.
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