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A Variation of Azygos Venous System with Absence of Hemiazygos and Accessory Hemiazygos Veins: A Case Report

AUTHORS

avatar Mohsen Eslami Farsani ORCID 1 , avatar Reihaneh Seyedebrahimi ORCID 1 , avatar Shima Ababzadeh ORCID 2 , avatar Maasoume Abdollahi 3 , avatar Fatemeh Heidari ORCID 1 , *

1 Anatomy Department, Faculty of Medicine, Qom University of Medical Sciences, Qom, IR Iran

2 Tissue Engineering Department, Faculty of Medicine, Qom University of Medical Sciences, IR Iran

3 Department of Anatomy, Faculty of Medicine, AJA University of Medical Sciences, Tehran, IR Iran

How to Cite: Eslami Farsani M, Seyedebrahimi R, Ababzadeh S , Abdollahi M , Heidari F. A Variation of Azygos Venous System with Absence of Hemiazygos and Accessory Hemiazygos Veins: A Case Report. Int Cardio Res J. 2022;16(1):e121073.

ARTICLE INFORMATION

International Cardiovascular Research Journal: 16 (1); e121073
Published Online: March 01, 2022
Article Type: Case Report
Received: November 09, 2021
Accepted: February 16, 2022
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Abstract

Introduction: The structure of the azygos venous system often has different variations.
There are many variations in origin, course, tributaries, anastomosis, and termination in
the azygos vein. Embryologically, the azygos venous system originates from subcardinal
veins, and changes in the azygos venous system development create several variations.
Case Presentation: The azygos vein system was evaluated in the cadaver of a 55-yearold
man whose hemiazygos and accessory hemiazygos veins could not be found. The
right posterior intercostal veins directly opened into the azygos vein. There was no
variation in the right side, while there was a variation in the drainage of the left posterior
intercostal veins. The first left posterior intercostal vein was directly drained into the
brachiocephalic vein, while the second, third, and fourth left posterior intercostal veins
were drained to the azygos vein through the left superior intercostal vein. Besides, a
connection was formed between the fifth and sixth left posterior intercostal veins
before being drained to the azygos vein. There was also a short connection between the
seventh and eighth left posterior intercostal veins. The connection between the tenth
and eleventh left posterior intercostal veins was formed on one anastomotic circle and
this common trunk was opened to the azygos vein near the entrance to the ninth left
posterior intercostal vein.
Conclusion: The present case was consistent with type III in the Anson classification
system with the prevalence of 1-5%. Variations of the hemiazygos and accessory
hemiazygos veins were confirmed by means of computerized tomography. This could
precisely clarify one of the variations of the mediastinal vessels. The embryological
pattern of the azygos system for this variation was discussed, as well.

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