# A 24-Year-Old Male Patient With an Ostium Secundum Complex Atrial Defect Secondary to a Perforated Aneurysm With Inferior Vena Cava Agenesis

## TL;DR

A 24-year-old man with a rare heart defect and missing inferior vena cava underwent successful open-heart surgery and made a full recovery.

## Contribution

This case report highlights a rare combination of congenital heart defects and their successful surgical management.

## Key findings

- The patient had an ostium secundum atrial defect secondary to a perforated aneurysm and inferior vena cava agenesis.
- Open-heart surgery with a pericardium patch successfully repaired the defect with no residual shunts postoperatively.
- The patient showed favorable recovery and no complications during follow-up at one and three months.

## Abstract

The article describes a successful clinical outcome in the case of a 24-year-old male with a diagnosis of an ostium secundum atrial defect secondary to a perforated aneurysm associated with vena cava agenesis. During hospitalization, an echocardiogram revealed the presence of ostium secundum inter-atrial communication with a left to right shunt, a left ventricular ejection fraction (LVEF) of 60%, and mild pulmonary hypertension, measured at 40 mmHg. CT imaging showed anomalous dilation of the azygos vein (16.8 mm), associated with interruption of the vena cava in the intrahepatic and adrenal portion, continuing through the azygos system and draining into the superior vena cava. Open-heart surgery was performed with pericardium patch placement on the defect. Postoperative transthoracic echocardiography revealed a tracking of the interatrial septum, with adequate placement of the surgical patch and no evidence of residual short circuits. The postoperative recovery was favorable, and the patient was discharged five days after surgery. Outpatient monitoring at the first and third months showed no complications during physical examination and echocardiogram imaging.