Situs Inversus With Caval Filter

Young female with a third trimester pregnancy is found to have a pulmonary embolus. Pregnancy is a contraindication for anticoagulation. Placement of a temporary filter was requested.

 

Subtracted and unsubtracted images of an inferior vena cavagram demonstrates something unusual. The cava is to the left of the maternal spine. Also note the presence of the fetus and a prominent left collecting system and ureter, indicating the hydonephorsis of pregnancy.

 

 

There is something unusual about the above pulmonary angiogram. The catheter traverses the heart from the left. The mother has situs inversus totalis.

A caval filter was placed as usual, in the infra-renal position.

 

Situs Inversus With Caval Filter