Chronic total occlusion of the inferior vena cava: a rare phenomenon detected during right heart catheterization

Chronic total occlusion of the inferior vena cava is a rare entity. Although it mainly occurs during the course of chronic diseases, it may also appear as a complication of cardiovascular interventions. Total occlusion of the inferior vena cava was detected in a 64-year-old woman during right heart catheterization performed to evaluate her complaints of breathlessness and chest pain. She had mitral valve surgery of 20-year history. Venous blood coming from the lower extremities was found to be directed to the azygos vein through a wide collateral network, which was then transferred to the right atrium. Due to appropriate functioning of the azygos vein, the patient had remained totally asymptomatic until the onset of her complaints.