Percutaneous closure of patent ductus arteriosus via internal jugular vein in patient with interrupted inferior vena cava

Percutaneous closure of the patent ductus arteriosus (PDA) in patients with interrupted inferior vena cava (IVC) poses a technical challenge. A 5-year-old girl with PDA and interrupted IVC is described in this report. The diagnosis of interrupted IVC and azygos continuation was made in the catheterization laboratory through infrarenal IVC angiogram. The procedure was shifted to IJV approach, and the device was delivered using a standard technique which completely occluded the PDA. Although echocardiographic assessment of systemic venous drainage is essential before any percutaneous intervention, cardiac catheterization is the most reliable method to define the systemic drainage. While IVC interruption can come as a surprise during therapeutic catheterization, one should be aware of and prepared with alternative strategies.