CC-BY-NC-ND 4.0 · THORAC CARDIOV SURG Reports 2017; 06(01): e35-e36
DOI: 10.1055/s-0037-1608622
Case Report: Cardiac
Georg Thieme Verlag KG Stuttgart · New York

Posterior Nutcracker Phenomenon in a Patient with Left Atrial Isomerism

Stanislav Tsvelodub1, Léon M. Putman1, Andrea Gieselmann2, Hans-Hinrich Sievers1
  • 1Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany
  • 2Department of Pediatric Cardiology, Asklepios Children's Hospital Sankt Augustin, Sankt Augustin, Germany
Further Information

Publication History

27 July 2017

26 September 2017

Publication Date:
12 November 2017 (online)


Background Nutcracker phenomenon (NCP) can occur due to various anatomical anomalies. Anterior and posterior NCP are defined in the literature. Posterior NCP combined with left atrial isomerism is a rare condition.

Case description We present a rare case of an asymptomatic posterior NCP involving the azygos vein in a patient with a complex cardiovascular pathology with left atrial isomerism, left ventricular outflow tract obstruction, interrupted inferior vena cava, and azygos continuation.

Conclusion Detection of the NCP especially involving such a rare anatomical anomaly as an azygos continuation has a crucial importance for diagnostic and surgical procedures.

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors.

Informed Consent

Informed consent was waived off because this study included no personal information about the patient.