PMC3959062_01
Four chamber view showing a dilated azygos vein (Az) posterior to the descending aorta (Ao) = "Double vessel sign."
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F1
Fetal echocardiography showed the presence of a vessel posterior to the descending aorta in the four-chamber view ("Double vessel sign," Figure 1).
Three-vessel view showing a dilated superior vena cava. SVC = Superior vena cava; Ao = Aorta; PA = Pulmonary artery
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F2
The next clue came from the three-vessel view, which showed a dilated, prominent SVC [Figure 2].
Bi-caval view showing the section of liver in the sagittal plane. There is a gap between the supra-hepatic (SH) and infra-hepatic (IH) portions of the IVC, suggesting interruption of the intrahepatic portion of the IVC. A dilated azygos vein (Az) is also seen posterior to the infra-hepatic IVC. SH = Supra-hepatic IVC; IH = Infra-hepatic IVC; Sp = Spine; ST =Stomach
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F3
In the bi-caval view, the intra-hepatic portion of the inferior vena cava was found to be interrupted [Figure 3].
Three-vessel view showing azygos vein joining the SVC (arrow). SVC = Superior vena cava; ST = stomach
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F4
On tracing this vessel cranially, its connection with the superior vena cava was documented [Figure 4].
Post-natal echocardiography sub-xiphoid view showing a dilated SVC with the venous channel (azygos vein) running parallel to the descending aorta (arrow) and joining the SVC. SVC = superior vena cava; RA = right atrium; Az = azygos vein
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F5
Echocardiography confirmed the prenatal diagnosis of isolated inferior vena cava with azygos continuation to superior vena cava [Figure 5].