Interrupted Inferior Vena Cava and Duplicated Superior Vena Cavae Identified During Catheter Ablation

BACKGROUND: Interrupted inferior vena cava (IVC) and duplicated superior vena cavae (SVCs) are rare congenital venous anomalies. CASE SUMMARY: A 52-year-old woman with near-syncope, palpitations, and tinnitus was referred for catheter ablation of supraventricular arrhythmia. Fluoroscopy during femoral venous access revealed an atypical catheter course. Computed tomography angiography demonstrated an interrupted intrahepatic IVC with azygos continuation as well as duplicated SVCs with a left persistent SVC draining into an enlarged coronary sinus, preventing transvenous access and leading to abortion of the procedure. DISCUSSION: Recognition of congenital venous anomalies is essential, as they may predispose patients to arrhythmias, thromboembolic events, or procedural complications. TAKE-HOME MESSAGES: Patients with congenitally interrupted IVCs and duplicated SVCs may have increased risk for thromboembolic events and arrhythmias, respectively. Unexplained presentation or refractory resolution of these symptoms should prompt consideration of these venous anomalies and advanced imaging.