2008;28 (7): 1967-82. congenital malformations and anatomical variants. Doctors divide the liver into eight sections to map it for surgeries and tests. causes of dilated ivc and hepatic veins. 2013 Dec;99(23):1727-33. doi: 10.1136/heartjnl-2012-303465. It can also occur during pregnancy. The suprarenal IVC is composed of a segment of the right subcardinal vein that does not regress. Prognosis. 1 What does it mean to have a dilated IVC? Cardiac and Pulmonary Vascular Remodeling in Endurance Open Water Swimmers Assessed by Cardiac Magnetic Resonance: Impact of Sex and Sport Discipline. The primary utility of bedside ultrasound of the IVC is to aid in assessment of the intravascular volume status of the patient. Unauthorized use of these marks is strictly prohibited. What does IVC is dilated with respiratory variation mean? Ultrasound evaluation of the inferior vena cava (IVC) provides rapid, noninvasive assessment of a patients hemodynamic status at the bedside. Federal government websites often end in .gov or .mil. Download : Download high-res image (384KB) Download : Download full-size image . Liver biopsies and . What is the meaning of IVC dilatation in athletes? Passive hepatic congestion: cross-sectional imaging features. 2014 Feb;27(2):155-62. doi: 10.1016/j.echo.2013.09.002. General imaging differential considerations include: Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Patients may be asymptomatic, or they may present only after complications occur. Symptoms usually result from abdominal distention. This dual, reciprocally compensatory blood supply provides some protection from hepatic ischemia in healthy people. When portal vein blood flow increases, hepatic artery flow decreases and vice versa (the hepatic arterial buffer response). Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-22516. Although the liver has a dual blood supply, the hepatic veins provide the sole route of egress for blood exiting the liver. Passive hepatic congestion, also known as congested liver in cardiac disease, describes the stasis of blood in the hepatic parenchyma, due to impaired hepatic venousdrainage, which leads to the dilation of central hepatic veins and hepatomegaly. Systemic venous diameters, collapsibility indices, and right atrial measurements in normal pediatric subjects. Anatomy. Causes of L-CHF were DMVD (n = 22), dilated cardiomyopathy (6), patent ductus arteriosus (1), and bradyarrhythmia (1). Despite its dual blood supply, the liver, a metabolically active organ, can be injured by. 46. Mark Gurarie is a freelance writer, editor, and adjunct lecturer of writing composition at George Washington University. Indeed, it is the only thing that ever has.". People with Deep Vein Thrombosis (DVT), or those who have blood clots in a deep leg vein, are at risk for IVC blockage. Nevertheless, it is proved that provoking factors can be: high blood coagulability; altered biochemical composition of blood; infectious venous diseases; hereditary factor. Measuring read more , blood-filled cystic spaces develop in the sinusoids (microvascular anastomoses between the portal and hepatic veins). The cause is often a blood clot or growth. At this level, the diameter of the cbd in 6 c Two pregnancies with fetal hydrops due to a small heart and Spectral wave analysis helps in evaluating the direction of flow and velocities in portal and hepatic veins ,. Other possible causes of liver disease that would lead to portal hypertension include: hemochromatosis alpha 1-antitrypsin deficiency hepatitis B chronic hepatitis C alcohol-related liver. Changing the subject to share a new Medical issue. nance imaging showed normal hepatic vein and inferior vena cava without obstruction, but dilated PV. In peliosis hepatis Peliosis Hepatis Peliosis hepatis is typically an asymptomatic disorder in which multiple blood-filled cystic spaces develop randomly in the liver. Elevated pulmonary arterial pressure in cor pulmonale causes dilatation of the IVC. Why should the patient perform a sniff? Thank you, {{form.email}}, for signing up. The lungs and lymphatic system are most often affected, but read more , and noncirrhotic portal hypertension Portal Hypertension Portal hypertension is elevated pressure in the portal vein. Wilson disease is present at birth, but symptoms usually start between ages 5 and 35. The link you have selected will take you to a third-party website. COVID-19 Screening in the Pediatric Emergency Department. Dilated cardiomyopathy is an infrequent cause of portal hypertension and portosystemic collaterals. Scott Sundick, MD, is a board-certified vascular and endovascular surgeon. These segments occur from the formation, fusion and regression of paired cardinal veins. {"url":"/signup-modal-props.json?lang=us"}, Di Muzio B, Weerakkody Y, Rock P, et al. Mesin L, Policastro P, Albani S, Petersen C, Sciarrone P, Taddei C, Giannoni A. J Clin Med. Any dilatation may indicate obstr. Clots of the hepatic veins lead to a rare disorder called Budd-Chiari syndrome. Pregnant women with inferior vena cava syndrome may experience lightheadedness and low blood pressure when they lie on their backs. Other ancillary findings in such cases include dilated IVC (diameter >2.5 cm) and hepatic veins with abnormal spectral waveform [13]. Accessibility The trusted provider of medical information since 1899, Overview of Vascular Disorders of the Liver, Last review/revision Jan 2022 | Modified Sep 2022. Bethesda, MD 20894, Web Policies Obstruction can be, Extrahepatic portal vein thrombosis Portal Vein Thrombosis Portal vein thrombosis causes portal hypertension and consequent gastrointestinal bleeding from varices, usually in the lower esophagus or stomach. Venkateshvaran A, Seidova N, Tureli HO, Kjellstrm B, Lund LH, Tossavainen E, Lindquist P. Int J Cardiovasc Imaging. At 3.8 cm left atrium should be normal,but did they measure left atrial cavity area during systole? The hepatic artery may be occluded Hepatic Artery Occlusion Causes of hepatic artery occlusion include thrombosis (eg, due to hypercoagulability disorders, severe arteriosclerosis, or vasculitis), emboli (eg, due to endocarditis, tumors, therapeutic read more . This blood is a mixture of blood from the hepatic artery and from the portal vein. Aged Atrial Function, Right Female Heart Atria / pathology, A dilated inferior vena cava is a marker of poor survival A dilated inferior vena cava is a marker of poor survival, IVC dilatation probably represents adaptation of an extracardiac structure to chronic strenuous exercise in top-level, elite athletes. Large IVC aneurysm (A, dash circle) associated with dilated left renal veins (A, arrows) and left renal vein thrombosis (B, star). o [ abdominal pain pediatric ] It results from increased pressure in a vein called the vena cava and can be a sign of heart . Asymptomatic elevation of serum liver enzymes may also occur 4. 001). 2019. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. IVC, inferior vena cava. 7). We propose that in healthy subjects (without volume overload, pericardial disease, and right heart abnormalities), dilated IVC may be a marker of decreased abdominal venous tone and/or increased compliance. ISBN:0721648363. Unable to process the form. Use for phrases The three main hepatic veins link up at the top of your liver at the inferior vena cava, a large vein that drains the liver to your right heart chamber. All forms of heart disease (congenital or acquired) are linked to passive hepatic congestion. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-22516, Case 1: congestive hepatopathy and ascites, View Bruno Di Muzio's current disclosures, View Yuranga Weerakkody's current disclosures, see full revision history and disclosures, World Health Organisation 2001 classification of hepatic hydatid cysts, recurrent pyogenic (Oriental) cholangitis, combined hepatocellular and cholangiocarcinoma, inflammatory myofibroblastic tumour (inflammatory pseudotumour), portal vein thrombosis (acute and chronic), cavernous transformation of the portal vein, congenital extrahepatic portosystemic shunt classification, congenital intrahepatic portosystemic shunt classification, transjugular intrahepatic portosystemic shunt (TIPS), transient hepatic attenuation differences (THAD), transient hepatic intensity differences (THID), total anomalous pulmonary venous return (TAPVR), hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu disease), cystic pancreatic mass differential diagnosis, pancreatic perivascular epithelioid cell tumour (PEComa), pancreatic mature cystic teratoma (dermoid), revised Atlanta classification of acute pancreatitis, acute peripancreatic fluid collection (APFC), hypertriglyceridaemia-induced pancreatitis, pancreatitis associated with cystic fibrosis, low phospholipid-associated cholelithiasis syndrome, diffuse gallbladder wall thickening (differential), focal gallbladder wall thickening (differential), ceftriaxone-associated gallbladder pseudolithiasis, biliary intraepithelial neoplasia (BilIN), intraductal papillary neoplasm of the bile duct (IPNB), intraductal tubulopapillary neoplasm (ITPN) of the bile duct, multiple biliary hamartomas (von Meyenburg complexes), dilated IVC/hepatic veins, hepatomegaly, ascites, mean diameter: 8.8 mm (in passive congestion), spectral velocity pattern (lVC & hepatic veins), flattening of Doppler waveform in hepatic veins, to-and-fro motion in hepatic veins and IVC, increased pulsatility of the portal venous Doppler signal, early enhancement of dilated IVC and hepatic veins due to contrast reflux from the right atrium into IVC, heterogeneous, mottled and reticulated mosaic parenchymal pattern with areas of poor enhancement, peripheral large patchy areas of poor/delayed enhancement, periportal low attenuation (perivascular lymphoedema). Mosby. o [ pediatric abdominal pain ] Is Clostridium difficile Gram-positive or negative? Mosby. James D. Nicolantonio, PharmD, urges us to reconsider decades-long dietary guidelines. The IVC is a thin-walled compliant vessel that adjusts to the bodys volume status by changing its diameter depending on the total body fluid volume. Early in the course of the disease, the main abnormality is enlargement of the right hepatic lobe. eCollection 2021. A blockage in one of the hepatic veins may damage your liver. Hepatic vein disorders can result in focal or diffuse venous obstruction. Without treatment, it can lead to liver failure, cirrhosis (scarring in the liver), or other serious problems. MeSH We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Budd-Chiari syndrome is diagnosed through a physical examination and with certain tests. The IVC diameter is affected by right heart function, as well as conditions like IVC aneurysm or Budd-Chiari syndrome (BCS), which directly or indirectly increase the volume of the blood in the right heart or increase the back pressure on the systemic circulation ultimately leading to IVC dilation [2,3]. Doctors use echocardiograms to help them diagnose heart problems, such as damaged cardiac tissue, chamber enlargement, stiffening of the heart muscle, blood clots in the heart, fluid around the heart, and damaged or poorly functioning heart valves. Its hard work. Clots of the hepatic veins lead to a rare disorder called Budd-Chiari syndrome. This disease is characterized by swelling in the liver, and spleen, caused by the interrupted blood flow as a result of these blockages. Martnez V, Sanz-de la Garza M, Domenech-Ximenos B, Fernndez C, Garca-Alvarez A, Prat-Gonzlez S, Yanguas C, Sitges M. Front Cardiovasc Med. The hepatic artery (which is oxygen-rich) supplies the rest. Manifestations read more ) or in the intrahepatic terminal hepatic venules and hepatic sinusoids (sinusoidal obstruction syndrome Sinusoidal Obstruction Syndrome Hepatic sinusoidal obstruction syndrome is caused by endothelial injury, leading to nonthrombotic occlusion of the terminal hepatic venules and hepatic sinusoids, rather than of the hepatic read more , previously called veno-occlusive disease) but often occurs in both. Check for errors and try again. state that IVC diameter 2.1 cm that collapses >50% with a sniff suggests normal RA pressure (RAP, range 05 mmHg), whereas IVC diameter > 2.1 cm that collapses <50% suggests high RAP (range 1020 mmHg). The https:// ensures that you are connecting to the What causes enlarged inferior vena cava? The normal Doppler waveform obtained from the HVs is tripha-sic (Fig. An IVC diameter greater than 20 mm is commonly regarded as an upper limit of normal, which is a noninvasive indication of increased RA pressure in patients with cardiac or renal disease [4]. 1. Results: The IVC diameter varied from 0.46 to 2.26cm in the study individuals. Background: Hepatic portal vein collateral circulation plays an important role in maintaining the perfusion of hepatic portal vein.However, at present, there is little research on collateral circulation of hepatic portal vein. This condition is characterised by bacterial thrombophlebitis in the hepatic venous opening of IVC which on resolution could form a membrane or a stenosis or a thick obstruction followed by collaterals. Radiopaedia. 1994;162 (1): 71-5. It also increases pressure on these veins, and fluid may build up in the abdomen. Macroscopically CT and MRI are able to depict cirrhotic changes as non-specific findings. Before MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. It can also occur during pregnancy. To clarify the etiology, liver biopsy was performed and the pathologi-cal features were as follows: hematoxylin and eosin Congenital thrombosis of the IVC is often asymptomatic which is caused by well-developed collaterals. How is Budd-Chiari syndrome diagnosed? 2016 Dec;42(12):2794-2802. doi: 10.1016/j.ultrasmedbio.2016.07.003. All forms of heart disease (congenital or acquired) are linked to passive hepatic congestion. The treatment of vena cava compression syndromes commonly involves stenting or radiation. Conclusion: A dilated IVC without collapse with inspiration is associated with worse survival in men independent of a history of heart failure, other comorbidities, ventricular function, and pulmonary artery pressure. A dilated IVC (>2 cm) has been found to indicate high RA pressure, particularly when there is no collapse during inspiration. AJR Am J Roentgenol. General imaging differential considerations include: Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Others may undergo an invasive surgery to try to correct the condition. ] Splenomegaly is almost always secondary to other disorders. By using this Site you agree to the following, By using this Site you agree to the following, The Best IOL for 2022 RXSight Light Adjusted Lens, Will refractive surgery such as LASIK keep me out of glasses all my life. It also increases pressure on these veins, and fluid may build up in the abdomen. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. causes of dilated ivc and hepatic veinswhat is naimisharanya kshetrawhat is naimisharanya kshetra Addi-tionally, gastroscopy showed esophageal vein exposure and portal hypertensive gastropathy. Can you use a Shark steam mop on hardwood floors? Saunders. Specific vascular lesions may occur in the hepatic artery, hepatic vein, or portal vein. Copyright 2023 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. The obstruction of the IVC is mostly caused by a primary thrombotic event [1], either congenital or acquired. What do the C cells of the thyroid secrete? Measures reflect the median values between maximal inspiratory and expiratory values. 2. pump failure over days to weeks. The inferior vena cava carries deoxygenated blood from your liver and the lower half of your body to the right side of your heart. These include:. If you continue to use this site we will assume that you are happy with it. Gore RM, Mathieu DG, White EM et-al. A) hepatic artery B) intestinal tract C) splenic artery D) peripheral venous system B) intestinal tract The arterial supply to the gallbladder is via the: A) hepatic artery B) superior mesenteric artery C) cystic artery D) gastroduodenal artery C) cystic artery The portal venous system receives blood from all of the following except the: Passive hepatic congestion. Macroscopically CT and MRI are able to depict cirrhotic changes as non-specific findings. Im thinking about having a baby in near future. The liver has a unique, dual blood supply in which 25% of the flow comes from the hepatic artery and 75% through the portal vein ( Fig. Pakistan Urology 36 years experience. At the time the article was created Bruno Di Muzio had no recorded disclosures. In adults, an IVC collapsibility index of greater than 50% is associated with reduced right atrial pressure and severe dehydration, and indicates that the patient needs fluid therapy(23). What is the shape of C Indologenes bacteria? hepatic veins and suprahepatic IVC:early enhancement due to reflux from the atrium, portal vein:diminished, delayed or absent enhancement. Two dogs had confirmed neoplastic obstructions, and the other dog had a suspected neoplastic obstruction of the hepatic veins and caudal vena cava. The right hepatic vein is the largest. Consequences read more , reduced portal blood flow, ascites Ascites Ascites is free fluid in the peritoneal cavity. Overview. Inferior Vena Cava may appear congested when its dilated without any respiratory variation collapsed with very small diameter through the respiratory cycle, or compliant and vary through respiratory cycle. The IVC diameter ranged from 0.97 to 2.26cm during expiration and from 0.46 to 1.54cm during inspiration. It is named after the cut appearance of the nutmeg seed. A large vein that carries blood to the heart from other areas of the body. The segmental anatomy of the liver as defined by the French surgeon Claude Couinaud [] divides the liver into eight segments, with portal vein branches at the center and hepatic veins at the periphery.The right, middle, and left hepatic veins enter the . Patients with inferior vena caval (IVC) thrombosis (IVCT) may present with a spectrum of signs and symptoms. Epub 2021 Jun 19. Treatment read more due to a hypercoagulable state, a vessel wall lesion (eg, pylephlebitis, omphalitis), an adjacent lesion (eg, pancreatitis Overview of Pancreatitis Pancreatitis is classified as either acute or chronic. Zakim D, Boyer TD. The inferior vena cava (IVC)is a large venous structure which delivers blood into the right atrium of the heart. Liver dysfunction and corresponding clinical signs and symptoms typically manifest late in the disease process. Dialysis a treatment that filters your blood through a machine. The livers tasks include converting nutrients passed from your digestive tract into energy, getting rid of toxins, and sorting out waste that your kidneys flush out as pee. Prolonged exposure to elevated hepatic venous pressure may lead to liver fibrosis and cirrhosis. Other symptoms include fatigue, abdominal pain, jaundice (a yellowing of the skin), nausea, and bleeding in the esophagus of the throat.. (See also Overview of the Spleen.) 2021 Aug 20;8:719113. doi: 10.3389/fcvm.2021.719113. We use cookies to ensure that we give you the best experience on our website. Yes, the report labeled the measurement as the Left Atrium Internal Diameter Systole. Become a Gold Supporter and see no third-party ads. Measurements taken at the junction of the right atrium and IVC are not equivalent to the other sites; clinicians should avoid measuring percentage collapse of . government site. 1. One is the hepatic artery, which brings in oxygen-rich blood from the heart. 7 Which is worse a dilated IVC or a collapsed IVC? The implantation of the IVC filter involves a local anesthetic and numbing medication injected in your skin in the area that the IVC filter will be inserted, preventing discomfort during the surgery. Inferior vena cava (IVC) is a large collapsible vein whose diameter and extent of inspiratory collapse are known to correlate with right atrial (RA) pressures; hence, IVC dilatation represents a cardiac pathology. What causes enlargement of the hearts right atrium? CT of nonneoplastic hepatic vascular and perfusion disorders. Systematic review and meta-analysis of training mode, imaging modality and body size influences on the morphology and function of the male athlete's heart. The renal segment of the IVC is formed by the anastomosis between the right subcardinal and right supracardinal veins. Created for people with ongoing healthcare needs but benefits everyone. Obstruction can occur in the intrahepatic or extrahepatic veins (Budd-Chiari syndrome Budd-Chiari Syndrome Budd-Chiari syndrome is obstruction of hepatic venous outflow that originates anywhere from the small hepatic veins inside the liver to the inferior vena cava and right atrium. Study with Quizlet and memorize flashcards containing terms like The portal veins carry blood from the ______________ to the liver. The right atrial cavity area is 21.0cm during systole The inferior vena cava appears dilated measuring 2.20cm.The vessel collapses with inspiration.The tricuspid valve is normal.There is trivial tricuspid regurgigation.Regurgitant velocity is 311.0cm/s and estimated RV systolic pressure is 43mmHg consistent with mild pulmonary hypertension." A couple of the more important are to determine right atrial pressure or central venous pressure, determining the pulmonary artery pressure as well as assessing fluid levels in the patient. The IVC diameter is altered with volume status and respiration, with higher IVC diameter during expiration than inspiration. On the bottom end of the liver are the organs unusual double blood supplies. National Institutes of Health and Human Services. The most common cause of portal hypertension is cirrhosis (scarring) of the liver. A Doppler echocardiographic study from the right parasternal approach. Bottom Line. The wedge-shaped organ is your largest one after your skin. Anatomically, theyre often used as landmarks indicating portions of the liver, though there can be a great deal of variation in their structure.. Symptoms that may indicate this syndrome include difficulty breathing, coughing, and swelling of the face, neck, upper body, and arms . Our study aims to analysis the imaging types and clinical value of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) invading and completely blocking . Although the liver has a dual blood supply, the hepatic veins provide the sole route of egress for blood exiting the liver. We provide pathologic evidence for hepatic arterial buffer response in non-cirrhotic patients with extrahepatic portal vein thrombosis and elucidate the histopathologic spectrum of non-cirrhotic portal vein thrombosis. 2018;10(10):283-293. doi:10.4253/wjge.v10.i10.283. The superior vena cava carries blood from the head, neck, arms, and chest. 2005 - 2023 WebMD LLC. What does a dilated inferior vena cava mean? These clinical manifestations of constrictive pericarditis are similar to those due to a cardiomyopathy. It is necessary to have the patient perform a sniff during the evaluation of the IVC. form hemopericardium = cardiac tamponade. hepatic cirrhosis is the leading cause of portal hypertension and is usually . A dilated IVC (>1.7 cm) with normal inspiratory collapse (>50%) is suggestive of a mildly elevated RA pressure (610 mm Hg). The most characteristic sign is a rusty brown ring around the cornea of the eye. It can be caused by physical invasion or compression by a pathological process or by thrombosis within the vein itself. This phasicity is dependent on varia-tions in central venous pressure during the cardiac cycle. Minagoe S, Yoshikawa J, Yoshida K, Akasaka T, Shakudo M, Maeda K, Tei C. Circulation. In severe cases, you may need a liver transplant. Your three main hepatic veins run between the eight segments like borders. The cause is often a blood clot or growth. We do not control or have responsibility for the content of any third-party site. hepatic veins and suprahepatic IVC:early enhancement due to reflux from the atrium, portal vein:diminished, delayed or absent enhancement. Consequences read more . Careful review of the echocardiographic images showed nodular thickening of the pericardium in the AV groove, without significant thickening of the whole pericardium. The IVC is composed of four segments: hepatic, prerenal, renal and postrenal. marilyn mulvey opera singer; hidden cosmetics owner; pre insulated pex pipe This results in a micronodular cirrhosis, which is indistinguishable from cirrhosis produced by other causes 2. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). (2009) ISBN:0323053750. Passive hepatic congestion is a well-studied result of acute or chronic right-sided heart failure. Cirrhosis is the most common cause of diffuse intrahepatic venous outflow obstruction. Nutmeg liver refers to the mottled appearance of the liver as a result of hepatic venous congestion. Budd-Chiari syndrome is a rare disorder characterized by narrowing and obstruction (occlusion) of the veins of the liver (hepatic veins). They tend to be saccular and multiple. The 2008 ACEP Policy Statement on Emergency Ultrasound Guidelines includes the evaluation of intravascular volume status and estimation of central venous pressure (CVP) based on sonographic examination of the inferior vena cava (IVC). National Library of Medicine Inferior vena cava (IVC) thrombosis is a rare medical condition. Having DVT also increases the likelihood of a blood clot breaking off and traveling to the heart, lungs, or brain. Utomi V, Oxborough D, Whyte GP, Somauroo J, Sharma S, Shave R, Atkinson G, George K. Heart. Enter a Melbet promo code and get a generous bonus, An Insight into Coupons and a Secret Bonus, Organic Hacks to Tweak Audio Recording for Videos Production, Bring Back Life to Your Graphic Images- Used Best Graphic Design Software, New Google Update and Future of Interstitial Ads. Following the recommendations of ASE guidelines developed in conjunction with the European Association of Echocardiography (EAE), the IVC was described as small when the diameter was <1.2 cm, normal when the diameter measured between 1.2 and 1.7 cm, and dilated when it measured >1.72.5 cm, markedly dilated when it > . (See also Overview of Vascular Disorders read more develop. What is portal circulation? The .gov means its official. The IVC diameter can be measured either close to its entrance to the right atrium or 1 to 2 cm caudal to the hepatic veinIVC junction (approximately 34 cm from the junction of the IVC and the right atrium). Causes include infection, arteriosclerosis, trauma, and vasculitis. a. Hepatic artery b. Intestinal tract c. Splenic artery d. Peripheral venous system, The arterial supply to the gallbladder is via the: a. Hepatic artery b. Non-Invasive Estimation of Right Atrial Pressure Using a Semi-Automated Echocardiographic Tool for Inferior Vena Cava Edge-Tracking. Indian J Crit Care Med. (2009) ISBN:0323053750. They can be congenital or acquired and occur within or outside the liver. A normal result is when the hearts chambers and valves appear typical and work the way they should.