Interrupted Inferior Vena Cava With Azygos Continuation—A Procedural Challenge During Transcatheter Aortic Valve Replacement: A Case Report

Interrupted inferior vena cava with azygos continuation is a rare congenital venous anomaly characterized by the absence of the hepatic segment of the inferior vena cava, with venous return from the lower extremities redirected through a dilated azygos vein into the superior vena cava. Although typically clinically silent, this anomaly can pose significant challenges during transcatheter procedures requiring femoral venous access. We describe a case of interrupted inferior vena cava with azygos continuation that was incidentally discovered during transcatheter aortic valve replacement after difficulty advancing a temporary transvenous pacemaker via the femoral venous approach.