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3.
Medicine (Baltimore) ; 103(13): e37625, 2024 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-38552073

RESUMEN

RATIONALE: Situs inversus totalis is a rare malposition of organs that typically involves lesions in the respiratory, circulatory, or urinary systems. Cases of congenital hemivertebrae combined with situs inversus totalis are extremely rare and have limited reports. PATIENT CONCERNS: We report a 2.5 years old girl with 2 congenital hemipyramids and complete visceral inversion who ultimately underwent hemilaminectomy. DIAGNOSIS: Congenital hemivertebrae combined with situs inversus totalis. INTERVENTION: The patient underwent hemilaminectomy. OUTCOMES: The spinal deformity was corrected. LESSONS: For patient with spinal deformities combined with situs inversus totalis, surgery can be an effective treatment method. But we also need to be vigilant about the dysfunction of various systems.


Asunto(s)
Dextrocardia , Anomalías Musculoesqueléticas , Situs Inversus , Femenino , Humanos , Preescolar , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen , Dextrocardia/cirugía , Situs Inversus/complicaciones , Situs Inversus/diagnóstico por imagen , Anomalías Musculoesqueléticas/cirugía , Laminectomía , Resultado del Tratamiento
4.
BMC Cardiovasc Disord ; 24(1): 22, 2024 01 03.
Artículo en Inglés | MEDLINE | ID: mdl-38172727

RESUMEN

BACKGROUND: We aimed to identify the ideal chest compression site for cardiopulmonary resuscitation (CPR) in patients with a single ventricle with dextrocardia corrected by Fontan surgery. METHODS: The most recent stored chest computed tomography images of all patients with a single ventricle who underwent Fontan surgery were retrospectively analysed. We reported that the ideal chest compression site is the largest part of the compressed single ventricle. To identify the ideal chest compression site, we measured the distance from the midline of the sternum to the point of the maximum sagittal area of the single ventricle as a deviation and calculated the area fraction of the compressed structures. RESULTS: 58 patients (67.2% male) were analysed. The mean right deviation from the midline of the sternum to the ideal compression site was similar to the mean sternum width (32.85 ± 15.61 vs. 31.05 ± 6.75 mm). When chest compression was performed at the ideal site, the area fraction of the single ventricle significantly increased by 7%, which was greater than that of conventional compression (0.15 ± 0.10 vs. 0.22 ± 0.11, P < 0.05). CONCLUSIONS: When performing CPR on a patient with Fontan circulation with dextrocardia, right-sided chest compression may be better than the conventional location.


Asunto(s)
Reanimación Cardiopulmonar , Dextrocardia , Procedimiento de Fontan , Humanos , Masculino , Femenino , Reanimación Cardiopulmonar/efectos adversos , Procedimiento de Fontan/efectos adversos , Estudios Retrospectivos , Esternón , Dextrocardia/diagnóstico por imagen
5.
J Int Med Res ; 51(10): 3000605231208594, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37903317

RESUMEN

Colon cancer in patients with situs inversus totalis is rarely associated with dextrocardia, and chemotherapy is commonly used for treatment. Central venous access devices are used to administer intravenous fluids and chemotherapy in patients with colon cancer. Compared with peripherally inserted central catheters and Hickman-type tunneled catheters, totally implantable vascular access devices (TIVADs) are safer and more effective. However, positioning the catheter tip may be challenging in patients with dextrocardia and situs inversus. We herein describe a novel case involving a patient with dextrocardia and colon cancer who was treated by TIVAD insertion with intracavitary electrocardiography-aided tip localization.


Asunto(s)
Catéteres Venosos Centrales , Neoplasias del Colon , Dextrocardia , Situs Inversus , Humanos , Catéteres de Permanencia/efectos adversos , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen , Situs Inversus/complicaciones , Neoplasias del Colon/complicaciones , Neoplasias del Colon/tratamiento farmacológico
6.
J Int Med Res ; 51(8): 3000605231189129, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37548409

RESUMEN

Dextrocardia is a rare cardiac malposition that was first described in 1606. Mirror-image dextrocardia is characterized by a mirror-image change of the normal position of the heart. Most cases are accompanied by situs inversus viscerum, whereas only 3% to 10% of cases are associated with intracardiac anomalies. Valve surgery for acquired valvular lesions in patients with mirror-image dextrocardia with situs inversus is rare. Diagnosing situs anomalies in adults is important to prevent errors during surgical operations, emergency procedures, or interventional operations. In this report, we present two cases of mitral regurgitation in patients with mirror-image dextrocardia. One patient had mirror-image dextrocardia with subacute infective endocarditis and mitral regurgitation, and the other patient had mirror-image dextrocardia with mitral Carpentier type I regurgitation. In both patients, mitral valve repair was successfully performed using a transseptal approach.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Dextrocardia , Insuficiencia de la Válvula Mitral , Situs Inversus , Adulto , Humanos , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen , Dextrocardia/cirugía , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/cirugía , Válvula Mitral/diagnóstico por imagen , Válvula Mitral/cirugía , Situs Inversus/complicaciones , Situs Inversus/diagnóstico por imagen , Situs Inversus/cirugía
7.
World J Pediatr Congenit Heart Surg ; 14(4): 524-526, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37282584

RESUMEN

The Konno-Rastan operation is performed for relief of complex left ventricular outflow obstruction with a small aortic annulus. When associated with situs inversus and dextrocardia, important aspects should be kept in mind due to the mirror-image anatomy. In this report, we present a case of a 10-year-old child with the diagnosis of recurrent diffuse subaortic stenosis and situs inversus and dextrocardia who underwent the Konno-Rastan operation successfully and was asymptomatic with normal physical activity after a follow-up period of one year.


Asunto(s)
Estenosis Aórtica Subvalvular , Cardiomiopatía Hipertrófica , Dextrocardia , Situs Inversus , Obstrucción del Flujo de Salida Ventricular Izquierda , Niño , Humanos , Situs Inversus/complicaciones , Situs Inversus/diagnóstico por imagen , Situs Inversus/cirugía , Cardiomiopatía Hipertrófica/complicaciones , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen , Dextrocardia/cirugía
8.
BMC Cardiovasc Disord ; 23(1): 265, 2023 05 20.
Artículo en Inglés | MEDLINE | ID: mdl-37210522

RESUMEN

BACKGROUND: Dextrocardia with situs inversus (DSI) is a very rare congenital anomaly. Catheter manipulation and ablation of atrial fibrillation (AF) in patients with this anatomical variant is challenging for the operators. This case report presents a safe and effective AF ablation guided by the robotic magnetic navigation (RMN) system in combination with intracardiac echocardiograhy (ICE) in a patient with DSI. CASE PRESENTATION: A 64-year-old male with DSI was referred for catheter ablation of symptomatic, drug-refractory paroxysmal AF. One transseptal access was achieved via the left femoral vein under the guidance of ICE. The three-dimensional reconstruction of the left atrium and the pulmonary veins (PVs) were performed by the magnetic catheter using the CARTO and the RMN system. Then, the electroanatomic map and pre-acquired CT images were merged. Finally, bilateral circumferential ablation lines were delivered around the ipsilateral PV ostia to achieve complete PV isolation (PVI). CONCLUSIONS: This case demonstrates that AF catheter ablation under the guidance of the RMN system using ICE is feasible and safe in a patient with DSI. Moreover, the combination of these technologies broadly facilitates treatment of patients with complex anatomy, while reducing the risk of complications.


Asunto(s)
Fibrilación Atrial , Ablación por Catéter , Dextrocardia , Venas Pulmonares , Procedimientos Quirúrgicos Robotizados , Situs Inversus , Masculino , Humanos , Persona de Mediana Edad , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/diagnóstico por imagen , Venas Pulmonares/diagnóstico por imagen , Venas Pulmonares/cirugía , Resultado del Tratamiento , Situs Inversus/complicaciones , Situs Inversus/diagnóstico por imagen , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen , Fenómenos Magnéticos , Ablación por Catéter/efectos adversos
9.
J Int Med Res ; 51(5): 3000605231169432, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37143333

RESUMEN

Peripherally inserted central venous catheters (PICCs) are widely used in cardiology because they are convenient, effective, and safe. However, PICC implantation in patients with mirror-image dextrocardia who have thoracic tumors has not yet been reported. In this case report, we describe a 46-year-old patient with lung cancer who had a thoracic inclination and left pulmonary artery compression of the superior vena cava. PICC implantation under B-ultrasound guidance was planned. Because of the anatomical differences caused by mirror-image dextrocardia, we investigated the optimal position and measurement method for the tip of the PICC according to the compression site of the vascular lumen through a multidisciplinary team approach. Electrocardiography-assisted tip positioning combined with postoperative chest X-ray positioning was performed for accurate positioning.


Asunto(s)
Cateterismo Venoso Central , Cateterismo Periférico , Catéteres Venosos Centrales , Dextrocardia , Humanos , Persona de Mediana Edad , Cateterismo Venoso Central/métodos , Vena Cava Superior/diagnóstico por imagen , Cateterismo Periférico/métodos , Grupo de Atención al Paciente , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen
10.
Vasc Endovascular Surg ; 57(1): 69-74, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35675973

RESUMEN

This manuscript describes an endovascular repair of a symptomatic, large proximal left subclavian artery aneurysm in a patient with dextrocardia and right-sided aortic arch and absent bilateral internal carotid arteries. The patient had surgical reconstruction as an infant for congenital heart disease with Ventricular Septal Defect, bifid sternum . Given her previous surgical history, we declined an open operation and performed an endovascular repair with stent grafts to successfully repair the subclavian artery aneurysm. The patient had an uneventful postoperative course and follow-up ultrasonography demonstrated successful repair with preservation of flow through the left subclavian and vertebral arteries with resolution of her symptoms.


Asunto(s)
Aneurisma , Aneurisma de la Aorta Torácica , Dextrocardia , Procedimientos Endovasculares , Humanos , Femenino , Arteria Subclavia/diagnóstico por imagen , Arteria Subclavia/cirugía , Arteria Subclavia/anomalías , Aneurisma de la Aorta Torácica/complicaciones , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/cirugía , Resultado del Tratamiento , Aneurisma/complicaciones , Aneurisma/diagnóstico por imagen , Aneurisma/cirugía , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen
12.
J Vasc Access ; 23(6): 962-965, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33977821

RESUMEN

Intracavitary electrocardiogram (ECG) has been widely used for PICC tip positioning in patients with a normal left heart. However, there is little information about using ECG for PICC insertion in patients with mirror dextrocardia. We report a 70-year-old stomach cancer patient with mirror dextrocardia admitted to our vascular access center for four Fr silicon Groshong PICC insertion. We successfully performed an ultrasound-guided modified Seldinger technique for insertion. First, the usual standardized ECG technique was used for tip positioning, and it failed. Then, we changed the procedure slightly, using the opposite electrode connections (RA: the first intercostal space of the midline of the left clavicle; LA: the first intercostal space of the midline of the right clavicle; and LL: the inferior margin of the right costal arch) to obtain an evident P-wave change to guide catheter placement in this case. We confirm that we can use the opposite electrodes to obtain an apparent P-wave for locating the catheter tip in patients with mirror dextrocardia.


Asunto(s)
Cateterismo Venoso Central , Cateterismo Periférico , Catéteres Venosos Centrales , Dextrocardia , Humanos , Anciano , Cateterismo Venoso Central/métodos , Cateterismo Periférico/métodos , Silicio , Electrocardiografía/métodos , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen
14.
World J Pediatr Congenit Heart Surg ; 13(2): 257-259, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34661458

RESUMEN

We report a case of a 2-year-old female presenting with cyanosis since birth and having rare cardiac anatomy of visceral situs inversus, dextrocardia, discordant atrioventricular connections with double outlet right ventricle, atrial communication, subaortic interventricular communication, anteriorly leftward aorta with right aortic arch, single coronary artery with a branch crossing right ventricle outflow tract, pulmonary stenosis, and bilateral superior vena cava. Corrective repair with atrial switch (Senning technique), intracardiac baffle, and right ventricle outflow reconstruction was successfully performed with challenges from altered anatomical location and orientation of the heart and abnormal coronary artery.


Asunto(s)
Dextrocardia , Ventrículo Derecho con Doble Salida , Defectos del Tabique Interventricular , Síndrome de Heterotaxia , Estenosis de la Válvula Pulmonar , Situs Inversus , Preescolar , Transposición Congénitamente Corregida de las Grandes Arterias , Vasos Coronarios , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen , Dextrocardia/cirugía , Ventrículo Derecho con Doble Salida/complicaciones , Ventrículo Derecho con Doble Salida/diagnóstico por imagen , Ventrículo Derecho con Doble Salida/cirugía , Femenino , Atrios Cardíacos/cirugía , Defectos del Tabique Interventricular/cirugía , Humanos , Estenosis de la Válvula Pulmonar/complicaciones , Estenosis de la Válvula Pulmonar/diagnóstico por imagen , Estenosis de la Válvula Pulmonar/cirugía , Situs Inversus/complicaciones , Situs Inversus/diagnóstico por imagen , Situs Inversus/cirugía , Vena Cava Superior
15.
Turk Kardiyol Dern Ars ; 49(7): 588-592, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34623303

RESUMEN

The procedure of stenting the patent ductus arteriosus (PDA) is a palliative procedure applied as an alternative to surgery in newborns with ductus-dependent pulmonary circulation. However, it is still a very challenging method in patients with aortic arch anomalies. We describe our experience with a newborn with right atrial isomerism and dextrocardia, complete atrioventricular septal defect, aortic outlet right ventricle with pulmonary atresia, right aortic arch, and a PDA from the left innominate artery. Because the PDA was long and tortuous, we preferred placing three short stents instead of a single long stent. The procedure applied the femoral artery approach with a Glidesheath Slender to decrease arterial injuries. PDA stenting in challenging morphologies can be performed successfully using multiple short stents and via Glidesheath Slenders.


Asunto(s)
Dextrocardia/diagnóstico , Conducto Arterioso Permeable/diagnóstico , Defectos de los Tabiques Cardíacos/diagnóstico , Atresia Pulmonar/diagnóstico , Stents , Angiografía por Tomografía Computarizada , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen , Dextrocardia/cirugía , Diagnóstico Diferencial , Conducto Arterioso Permeable/complicaciones , Conducto Arterioso Permeable/diagnóstico por imagen , Conducto Arterioso Permeable/cirugía , Femenino , Defectos de los Tabiques Cardíacos/complicaciones , Defectos de los Tabiques Cardíacos/diagnóstico por imagen , Defectos de los Tabiques Cardíacos/cirugía , Humanos , Recién Nacido , Atresia Pulmonar/complicaciones , Atresia Pulmonar/diagnóstico por imagen , Atresia Pulmonar/cirugía
17.
J Cardiothorac Surg ; 16(1): 211, 2021 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-34332582

RESUMEN

BACKGROUND: Total anomalous pulmonary venous return (TAPVR) refers to an anomaly in which all of the pulmonary veins drain directly or indirectly to the systemic venous circulation. However, unusual types constitute approximately 5% or less of TAPVRs and there may be obstruction or discontinuity of pulmonary vein at various levels. CASE PRESENTATION: A 3-month-old infant was presented to us with history of poor feeding, respiratory distress and desaturations. The routine echocardiographic investigation initially confirmed the diagnosis of an atrial septal defect with dextrocardia. However, due to disproportionate severity of symptoms and congestive heart failure a cardiac computer tomography angiogram was done that revealed a rare finding of connection of pulmonary veins fused with the posterior atrium, but on the rightward side of the deviated atrial septum. Therefore, pulmonary veins entered a sinus that drains directly into the right atrial superior-posterior wall. During surgical repair, we found an area of absent pericardium in the diaphragmatic surface of the heart. The patient underwent total repair of the TAPVR and patch reconstruction of the pericardial defect. The patient is doing well at 6-month follow up. CONCLUSIONS: The septum primum malposition defect resulting in TAPVR is a very rare congenital anomaly that can be rarely seen without any heterotaxy. The anomalous features including absent pericardium and dextrocardia were present in this patient have not been described previously with TAPVR. Therefore, we have hypothesized the embryological correlation of absent pericardium and cardiac malposition in such case. Transthoracic echocardiography with Doppler interrogation is a reliable method for diagnosing this condition. In case of suboptimal echocardiographic image due to cardiac position, unclear anatomy or unexplained symptoms, advanced imaging such as computer tomographic angiography or cardiac magnetic resonance imaging can be very helpful. Preoperative proper diagnosis of this anomaly facilitates successful surgical management with excellent outcome.


Asunto(s)
Tabique Interatrial , Dextrocardia , Defectos del Tabique Interatrial , Venas Pulmonares , Síndrome de Cimitarra , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen , Atrios Cardíacos , Defectos del Tabique Interatrial/diagnóstico por imagen , Defectos del Tabique Interatrial/cirugía , Humanos , Lactante , Pericardio/diagnóstico por imagen , Pericardio/cirugía , Venas Pulmonares/diagnóstico por imagen , Venas Pulmonares/cirugía , Síndrome de Cimitarra/diagnóstico por imagen , Síndrome de Cimitarra/cirugía , Vena Cava Superior
18.
J Card Surg ; 36(9): 3378-3380, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34148254

RESUMEN

Dextrocardia is a rare congenital cardiac positional anomaly. A 74-year-old woman was referred for aortic regurgitation (AR). Chest X-ray revealed a mildly enlarged heart that directed to the right side. Transthoracic echocardiography showed AR due to cusp prolapse with a dilated left ventricle and reduced wall motion. Computed tomography demonstrated the heart and great vessels in a mirror image of their normal positions. A median sternotomy performed by the surgeon standing on the right side of the patient. After establishing a cardiopulmonary bypass, the surgeon moved to the left side of the patient, and then performed aortic valve replacement.


Asunto(s)
Dextrocardia , Situs Inversus , Anciano , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen , Dextrocardia/cirugía , Ecocardiografía , Femenino , Humanos , Situs Inversus/complicaciones , Situs Inversus/diagnóstico por imagen , Situs Inversus/cirugía , Tomografía Computarizada por Rayos X
19.
R I Med J (2013) ; 104(5): 38-39, 2021 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-34044436

RESUMEN

Dextrocardia is a rare congenital disorder characterized by an anatomically flipped heart that is positioned in the right instead of the left side of the thorax. Anatomical variants, such as this, are vital to be aware of as they can alter patient monitoring and management. In this case report, we describe a patient with dextrocardia whose anatomy affected intraoperative monitoring while undergoing a successful aortic valve replacement surgery.


Asunto(s)
Dextrocardia , Prótesis Valvulares Cardíacas , Válvula Aórtica , Dextrocardia/diagnóstico por imagen , Humanos
20.
Eur J Cardiothorac Surg ; 60(4): 997-999, 2021 10 22.
Artículo en Inglés | MEDLINE | ID: mdl-33709153

RESUMEN

A 70-year-old female with symptomatic severe native aortic regurgitation, acquired dextrocardia, moderate-to-severe secondary mitral regurgitation and prohibitive surgical risk was admitted for transcatheter aortic valve replacement. A balloon-expendable Sapien 3 Ultra valve was implanted successfully. After 6 months, the patient remained symptomatic due to the concomitant moderate-to-severe secondary mitral regurgitation. Transcatheter mitral valve repair using a Carillon Mitral Contour System was performed resulting in a significant reduction of mitral regurgitation and uneventful follow-up. Most importantly, other transcatheter repair techniques would not have been feasible due to the impossible transoesophageal echocardiography guidance. This is the first case of transcatheter aortic valve replacement in a patient with native aortic regurgitation, acquired dextrocardia and severe aortic annulus malrotation using a balloon-expendable valve. Moreover, it is the first transcatheter mitral valve repair procedure using Carillon device performed by a cardiac surgeon.


Asunto(s)
Insuficiencia de la Válvula Aórtica , Dextrocardia , Implantación de Prótesis de Válvulas Cardíacas , Anuloplastia de la Válvula Mitral , Insuficiencia de la Válvula Mitral , Reemplazo de la Válvula Aórtica Transcatéter , Anciano , Válvula Aórtica/diagnóstico por imagen , Válvula Aórtica/cirugía , Insuficiencia de la Válvula Aórtica/diagnóstico por imagen , Insuficiencia de la Válvula Aórtica/cirugía , Dextrocardia/complicaciones , Dextrocardia/diagnóstico por imagen , Dextrocardia/cirugía , Femenino , Humanos , Válvula Mitral/diagnóstico por imagen , Válvula Mitral/cirugía , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/cirugía , Resultado del Tratamiento
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