Alternative variant of the Superior Vena Cava Anatomy – why should we stick to the rules

Abstract

Anatomical variants of the vein system are relatively common but in the system of inferior vena cava rather infrequent (0,2-3,0%). A lack of knowledge of possible anatomical variants in this area may cause procedural problems during surgical and invasive procedures and lead to serious complications. A case of 93 years old man admitted to the hospital for leadless pacemaker MICRA VR implantation is presented. He was diagnosed with dual inferior vena cava anatomy. Guidewire introduced by puncture of right femoral vein much “easier” was advanced to left inferior vena cava. Manoeuvring with a multipurpose catheter allowed to advance guidewire to right inferior vena cave and successfully complete the leadless pacemaker implantation procedure.