Ever heard of the obturator vein?

We report a complication related to advancement of a large diameter long sheath in the obturator vein. In an adult with a previously thrombosed femoral vein, the obturator vein was inadvertently cannulated. During percutaneous pulmonary valve implantation, the Ensemble® delivery system could not be advanced after repositioning attempt. The obturator vein had been perforated and sheath was coiled up in the pelvis leading to a retroperitoneal pelvic hematoma. Continuity of the vein was established using two self‐expanding covered stents. The obturator vein runs dorsally and joins the inferior caval vein at a very acute angle posterior in the pelvis, creating a corner in which stiff catheters or sheaths may get entrapped. © 2009 Wiley‐Liss, Inc.     

Abernethy malformation with unusual cardiac malformation: Case report and literature review

Abernethy malformation, also known as congenital extrahepatic shunt, is a rare anomaly, which is characterized by partial or complete diversion of the portal blood into the systemic venous circulation. The clinical manifestations of Abernethy malformation during childhood include neonatal cholestasis, failure to thrive, mental retardation, and other congenital defects. We report a case of Abernethy malformation Type II in a 9-year-old boy, whose left ventricle was slightly enlarged because of several major aortopulmonary collateral arteries (MAPCAs) but laboratory examinations were normal 5 years earlier. The characteristics of congenital heart disease in patients with Abernethy malformation are discussed. We propose that physicians should be aware of the possibility of Abernethy malformation in children with enlargement of the left ventricular due to systemic-pulmonary collateral circulation.