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Evaluation for prospective donors in live-related renal transplantation poses many challenges. Anatomical anomalies are no longer considered red flags as long as the functionality is maintained. Vascular anomalies increase difficulty during live donor nephrectomy. We herein report a case of live donor nephrectomy in a donor with a duplicated left-sided inferior vena cava (IVC). Adequate length of the left renal vein was got by taking a cuff off the duplicated IVC. The postoperative period was uneventful. Duplicated IVC is not a contraindication for left donor nephrectomy and detailed preoperative imaging helps in delineating and planning such cases. [ABSTRACT FROM AUTHOR]

Atrial fibrillation is the most common sustained cardiac arrhythmia in adults and it is associated with a high burden of mortality and morbidity worldwide. Catheter ablation is increasingly used to improve symptoms and prognosis in selected patients. Lower limb venous access with subsequent transseptal approach to the left atrium is the standard procedure for atrial fibrillation catheter ablation. We report an unusual case of complex venous anomaly with a left-sided inferior vena cava with hemiazygos continuation to a persistent left superior vena cava draining in an enlarged coronary sinus in a patient with persistent atrial fibrillation scheduled for transcatheter ablation. Lower limb venous anomalies may limit a standard transseptal approach to the left atrium thus precluding an effective catheter ablation procedure for atrial fibrillation. Alternative interventions, such as unconventional percutaneous access, thoracoscopic approach and "ablate and pace" procedures, may be necessary in patients with symptomatic atrial fibrillation and complex venous anomalies. [ABSTRACT FROM AUTHOR]

• Surgical planning based on preoperative CTA is necessary in patients with vascular anomalies in order to avoid complications. • Intrabdominal adhesions are common in patients with previous abdominal surgery and can affect the surgical approach for donor nephrectomy. • Considering the extension of the donor eligibility criteria, it is expected to see cases with congenital vascular anomalies. The extension of donor eligibility criteria represents one of the possible ways to increase the organ shortage, thus decreasing the waiting time for kidney transplantation. Expectedly, this strategy is associated with a growing number of more technically demanding living donor nephrectomy procedures requiring careful assessment, and sound surgical experience in order to avoid intraoperative complications. After a thorough evaluation through preoperative imaging, we performed a hand-assisted left laparoscopic living donor nephrectomy in a 56 year-old overweight patient with history of prior abdominal surgery, harboring a left-sided inferior vena cava (IVC). This case describes our comprehensive approach in this complex surgical scenario to preserve donor safety and provide an optimal kidney graft. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: We report a case of a ruptured abdominal aortic aneurysm (RAAA) with atypical localisation of inferior vena cava (IVC), successfully managed with open surgery repair. Case Report: A 52-year-old male patient presented with a 2-day duration of acute abdominal pain and acute left limb pain. Computed tomographic angiography demonstrated ruptured abdominal aortic aneurysm with massive retroperitoneal haematoma and occluded left superficial femoral artery. In addition, left-sided infrarenal IVC, ventrally crossing the aneurysmal neck, supposed difficult clamping and anastomosing. After transection of IVC, the AAA was successfully repaired with tube graft interposition. Subsequently, IVC was reconstructed with a short 20-mm Dacron graft. The patient had an uneventful recovery. Conclusion: The case demonstrates the importance of pre-operative imaging for successful treatment of RAAA in the presence of a challenging venous anomaly and one technical decision for this type of cases. [Copyright &y& Elsevier]