Percutaneous atrial septal defect closure through femoral and transjugular approaches in patients with interrupted inferior vena cava

Femoral venous approach is the classic route of percutaneous atrial septal defect (ASD) closure. But in patients with interrupted inferior vena cava (IVC) with azygos continuation the normal connection is lost rendering transcatheter intervention more complicated and innovative approaches should be sought. Transhepatic approach has been used with success but this approach is technically demanding and could lead to major complications. We report successful percutaneous secundum ASD closure in 2 patients with interrupted IVC. Transjugular route was used to close the secundum ASD in a 15-month-old girl. Percutaneous ASD closure through femoral venous route was performed in a 49-year-old woman. We found that both these approaches of percutaneous ASD device occlusion can be performed with success and safety. <Learning objective: Interrupted inferior vena cava with azygos or hemiazygos continuation is a rare congenital anomaly but potentially complicates the usual percutaneous atrial septal defect (ASD) closure and therefore merits an accurate diagnosis before the procedure. Percutaneous ASD device closure can be performed with success and safety through femoral and transjugular approaches in patients with ostium secundum ASD who present with interrupted inferior vena cava.>