No abstract

A 43-year-old woman with pulmonary fibrosis secondary to pulmonary alveolar proteinosis was scheduled to undergo lung transplantation. She had undergone multiple whole lung lavage on extracorporeal circulation (ECC) before lung transplantation which caused scarring of right femoral subcutaneous tissues. Preoperative examination revealed a double inferior vena cava (IVC) with interiliac communication and left IVC ended at left renal vein. Then, surgical exposure of the right femoral vessels was performed immediately after anesthetic induction for the emergent vascular access to establish ECC.Cardiopulmonary collapse did not occur and ECC was not required until lung resection. Lung transplantation was uneventfully completed. Congenital IVC anomaly is rare, but may make cannulation through the femoral vein difficult. Scarring of the subcutaneous tissue could result in a difficult "percutaneous" approach to the vessels. Evaluation of the vascular anatomy related to the establishment of ECC is important before lung transplantation.3