# Minimally Invasive Aortic Valve Replacement in a Patient With Interrupted Hepatic Inferior Vena Cava and Duplicated Inferior Vena Cava: A Case Report

## TL;DR

A 72-year-old woman with a rare vein anomaly successfully underwent minimally invasive heart surgery to replace her aortic valve.

## Contribution

This case report presents a successful MICS-AVR in a patient with a rare duplicated and interrupted inferior vena cava.

## Key findings

- MICS-AVR was successfully performed despite a rare vascular anomaly.
- Venous cannulation was achieved through alternative routes due to the anomaly.
- The patient recovered well and was discharged on postoperative day six.

## Abstract

We report a case of a 72-year-old female patient with severe aortic regurgitation and a rare congenital anomaly involving duplicated inferior vena cava (IVC) and interruption at the hepatic segment. She underwent minimally invasive cardiac surgery-aortic valve replacement (MICS-AVR) via right anterior thoracotomy. Venous cannulation was performed through the right internal jugular vein and right femoral vein, while arterial access was achieved through the right femoral artery. Despite suboptimal venous return, cardiopulmonary bypass (CPB) was initiated, and the procedure was completed successfully with hypothermic support. The patient recovered uneventfully and was discharged on postoperative day six. This case highlights the importance of thorough preoperative imaging and intraoperative vigilance when dealing with vascular anomalies in MICS.