[A patient without intracardiac ECG. Persistent azygos vein]

Area of Science:

• Cardiology
• Vascular Anatomy
• Electrophysiology

Background:

• Interruption of the inferior vena cava with azygos continuation is a rare congenital venous anomaly.
• Persistent azygos continuation of the inferior vena cava presents unique anatomical challenges for cardiovascular interventions.

Observation:

• A 17-year-old male patient presented with Wolf-Parkinson-White syndrome and a persistent vena azygos.
• The patient's complex venous anatomy required careful consideration for electrophysiological study and ablation.

Findings:

• Radiofrequency energy ablation of a lateral accessory pathway was successfully performed.
• A femoral retrograde approach was utilized, proving safe and effective in this complex case.

Implications:

• This case demonstrates the feasibility of safely ablating accessory pathways in patients with complex venous anomalies like interrupted inferior vena cava with azygos continuation.
• The findings support the use of standard interventional techniques, such as femoral retrograde access, for successful ablation in anatomically challenging scenarios.
• This successful intervention offers hope for patients with similar rare conditions, highlighting the importance of tailored approaches in electrophysiology.