Inferior Vena Cava Atresia, Thrombosis and Ulcerative Colitis

From her cheerful manner and upbeat attitude, Ara Walker constantly surprises people when they learn she lives with inferior vena cava atresia. 
 
Inferior vena cava atresia, or IVCA, refers to the absence of the inferior vena cava, a large vein that carries blood from the lower body to the heart so that it can be oxygenated. IVCA can occur as a congenital anomaly or it can develop secondary to a deep vein thrombosis (DVT), as it turned out in Ara’s case. Her IVC was malformed just below her kidneys, causing the blood flow in that area to be compromised. Her body has adapted by rerouting the blood flow through a series of smaller blood vessels, but that pathway is considerably less efficient and can cause the blood to pool and blood clots to form.
 
Like so many other young people with IVCA, Ara showed no symptoms during childhood.  She was an active teenager who enjoyed being a member of her high school’s marching band. But in the fall of 2020, when she had become lethargic and felt regularly sick, Ara visited her primary care physician and was given a steroid shot with the expectation that she would feel better quickly.  The next morning, though, her left leg was very swollen and painful. “It had doubled in size overnight,” she recalled.
Her doctor ordered an ultrasound, which revealed the cause of the pain and swelling Ara was experiencing. “My doctor said, ‘Ara has to go to Children’s of Alabama. She has a blood clot,” Ara said.

Ara and her mother immediately made the 45-minute drive to the Children’s of Alabama emergency department in Birmingham. There, Ara was admitted for what became a nine-day stay. During her hospitalization, Ara was diagnosed with an extensive DVT (blood clot) of nearly her entire left leg, anemia, and ulcerative colitis. She received a blood transfusion to help alleviate the anemia, underwent surgery to remove the blood clot, and began treatment for gastrointestinal issues associated with the colitis. 
Despite the initial surgery, the blood clot returned during her hospital stay, but Ara was able to manage it non-surgically for a few years until undergoing another surgery right after her high school graduation in 2024. During the six-hour procedure, several stents were placed to open Ara’s inferior vena cava so that blood flow would be improved. She returned to Children’s in May 2025 to have a smaller clot in her abdomen removed. 

IVCA has certainly impacted Ara’s life, decreasing her energy level and requiring daily medication and ongoing monitoring by her care team. But, while her health journey has been rocky at times, she approaches life with optimism and plans for her future. Like many of her peers, Ara works part-time in retail and has begun her college studies. “I’m just an average college student,” she said. “And I’m more than happy to be an average college student!”