Accessory Right and Left Hepatic Arteries in a 69 year-old White Female Donor with a Duplicated Inferior Vena Cava: Anatomical and Surgical Significance:

Julius Shepard; Kaitlin Porter; Maria Ximena Leighton; Gary Wind; Elizabeth Maynes; Keiko Meshida; Kerrie Lashley; Rodrigo Mateo; Jordan Dimitrakoff; Teresa Buescher; Joanne Lenert; Guinevere Granite

doi:10.61797/ijcsav.v5i1.320

Julius Shepard F. Edward Hebert School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA
Kaitlin Porter F. Edward Hebert School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA
Maria Ximena Leighton Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
Gary Wind Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
Elizabeth Maynes Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
Keiko Meshida The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20814, USA
Kerrie Lashley The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20814, USA
Rodrigo Mateo Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
Jordan Dimitrakoff Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
Teresa Buescher The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20814, USA
Joanne Lenert The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20814, USA
Guinevere Granite Director of Human Anatomy, Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, A3020C, Bethesda, MD, USA https://orcid.org/0000-0003-3953-2250

DOI: https://doi.org/10.61797/ijcsav.v5i1.320

Keywords: Accessory hepatic artery, Duplicated inferior vena cava, Embryologic development, Anatomical variation

Abstract

Hepatic artery variations are relatively common findings in patients with an array of findings that were categorized and quantified in the Michels classification system. Findings of an accessory right and left hepatic artery were found in a 69 year-old white female donor with a duplicated inferior vena cava during routine anatomical dissection (Michels type 7 variation). Research supports that the hepatic artery variations can be due to either failure of regression of ventral anastomosis between the dual aortas or failed regression of fetal hepatic blood flow. Given the concurrent development of the IVC and aortic branches during the fourth to seventh week of gestation, this patient’s duplicated IVC and abnormal CT and SMA anatomy are likely related, both a result of failure of regression of fetal vasculature. There are no known associated comorbidities with this vascular variation however it is clinically significant when undergoing any hepatobiliary surgical procedures and suggests an increased risk for hepatic ischemic events.

Accessory Right and Left Hepatic Arteries in a 69 year-old White Female Donor with a Duplicated Inferior Vena Cava: Anatomical and Surgical Significance

Accessory Right and Left Hepatic Arteries with a Duplicated Inferior Vena Cava

Abstract