Percutaneous device closure of a bifurcated inferior vena cava and completion of the Kawashima procedure for the "difficult" univentricular heart.

Azygos continuation of inferior venacava (IVC) is well known in association with interrupted IVC. We report azygos connection of uninterrupted IVC in a young child with complex univentricular heart. This peculiar anatomy was made suitable for univentricular repair by combining percutaneous device closure of prehepatic right limb of IVC and bidirectional Glenn shunt. The azygos vein acted as a conduit for IVC flow to superior venacava as in Kawashima's operation. This case highlights a rare IVC morphology. Also this innovative strategy allowed simple solution to a challenging problem and is first time described in the literature.