# Case Report: Incidental finding of an atresia of the inferior vena cava—a challenge for cardiac surgery

## TL;DR

This case report describes a rare anatomical condition, inferior vena cava atresia, encountered during cardiac surgery and successfully managed with proper preoperative planning.

## Contribution

The novelty lies in the successful management of a rare anatomical anomaly during cardiac surgery through comprehensive preoperative diagnostics and planning.

## Key findings

- Inferior vena cava atresia can be managed successfully during cardiac surgery with proper preoperative imaging.
- Standard cardiopulmonary bypass initialization was possible without unforeseen complications in this case.
- Preoperative CT angiography or MRI is crucial for surgical planning in such rare cases.

## Abstract

Inferior vena cava atresia is a rare and usually asymptomatic condition. However, when these patients undergo cardiac surgery, it can present an unexpected and challenging situation for the surgeon. Specifically, adequate venous drainage during cardiopulmonary bypass (CPB) is a critical issue here and may require an extension of cannulation strategies. Adequate preoperative diagnostics, ideally with imaging modalities such as CT angiography or MRI, are required for optimal surgical planning. Here, we describe a rare case of thoracic ascending aortic aneurysm with concomitant inferior vena cava atresia that was successfully operated on. With adequate preoperative planning, we were able to perform an operation without unforeseen complications with standard initialization of CPB.