Adrenal venous sampling in a patient with left inferior vena cava

Key Clinical Message Adrenal venous sampling (AVS), although difficult, is recommended for patients with primary aldosteronism (PA) to diagnose the subtype. Recognizing anatomical variation is key to a successful AVS. We report on a patient with PA and left inferior vena cava (IVC) whose left adrenal vein drained directly into the IVC.