1
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Vaid R, Fareed A, Ahmad Siddiqui M. Kartagener's Syndrome Complicated by Bronchiectasis with Tricuspid and Mitral Valve Regurgitation: A Case Report. Clin Med Insights Case Rep 2024; 17:11795476241251940. [PMID: 38706639 PMCID: PMC11069330 DOI: 10.1177/11795476241251940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
Background Kartagener's syndrome, a rare autosomal recessive genetic disorder, is characterized by primary ciliary dyskinesia (PCD), resulting in defective cilia function in the respiratory tract and fallopian tubes. Case presentation This case report discusses a 23-year-old female with Kartagener's syndrome, bronchiectasis, and cardiac involvement, who presented with shortness of breath, cough, and syncope. Notably, she received home oxygen therapy but became exhausted, leading to loss of consciousness. Clinical examination revealed prominent heart sounds and abnormal lung findings. Laboratory results indicated leukocytosis, and an ECG confirmed dextrocardia and cardiac abnormalities. Doppler studies identified mitral and tricuspid regurgitation along with severe pulmonary arterial hypertension. Antibiotics were administered for coagulase-negative Staphylococcus infection. The patient improved with a treatment regimen, including oxygenation and nebulization. Regular follow-up and patient education were emphasized. Conclusion This case underscores the complexity of Kartagener's syndrome and the importance of a multidisciplinary approach in managing its respiratory and cardiac manifestations.
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Affiliation(s)
- Rayyan Vaid
- Karachi Medical and Dental College, Karachi, Pakistan
| | - Areeba Fareed
- Karachi Medical and Dental College, Karachi, Pakistan
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2
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Jenab Y, Ghaemi O, Moosavi NS, Ghaderian H, Rafati A, Mohseni-Badalabadi R, Hedayat B, Hosseini K, Sarraf M. Transhepatic Access for Percutaneous Mitral Balloon Commissurotomy With Dextrocardia and Inferior Vena Cava Interruption. JACC Case Rep 2024; 29:102310. [PMID: 38576772 PMCID: PMC10990751 DOI: 10.1016/j.jaccas.2024.102310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 04/06/2024]
Abstract
We report a successful percutaneous mitral balloon commissurotomy via left transhepatic venous access in a 42-year-old female patient with dextrocardia, situs inversus totalis, and inferior vena cava interruption. fWe also discuss the revisions required for optimal trans-septal approach from the left transhepatic vein.
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Affiliation(s)
- Yaser Jenab
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Ghaemi
- Department of Radiology and Interventional Radiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Najme-Sadat Moosavi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Homa Ghaderian
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rafati
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Mohseni-Badalabadi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Hedayat
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kaveh Hosseini
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sarraf
- Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
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3
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Peñaloza S, Godoy M, Miranda R. Situs inversus totalis: A challenge for cardiac resynchronization therapy. Pacing Clin Electrophysiol 2024; 47:688-690. [PMID: 37697948 DOI: 10.1111/pace.14819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/04/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023]
Abstract
Situs inversus totalis (SIT) is a congenital condition in which the major visceral organs are reversed or in a mirror image from their normal positions that affects one per 10,000 live births. It is associated with dextrocardia (DXC) in which the heart is located on the right side of the chest. We present a challenging cardiac resynchronization therapy (CRT) implantation in a 60-year-old man with SIT-DXC, heart failure, extreme bradycardia, wide QRS, and left ventricular (LV) dysfunction. The procedure was complex due to the mirror-image anatomy and the tortuous origin of the coronary sinus (CS) branches that required a subselection catheter for adequate lead implantation.
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Affiliation(s)
- Sebastián Peñaloza
- Department of Internal Medicine, School of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Marcelo Godoy
- Department of Medical Specialties, School of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Rodrigo Miranda
- Department of Internal Medicine, School of Medicine, Universidad de La Frontera, Temuco, Chile
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4
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Viggiani G, Ibrahim T, Allescher J, Steger A. Be prepared for the unexpected: Mind-stretching in ST-elevation myocardial infarction with situs inversus totalis. Clin Case Rep 2024; 12:e8768. [PMID: 38681040 PMCID: PMC11043088 DOI: 10.1002/ccr3.8768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/18/2024] [Accepted: 03/27/2024] [Indexed: 05/01/2024] Open
Abstract
Situs inversus totalis is a rare diagnosis, but the likelihood of experiencing myocardial infarction is presumed to be comparable to the general population average. In individuals exhibiting situs inversus with suspected myocardial infarction, ECG recording, including right precordial leads, is crucial for diagnostic assessment. Coronary angiography and intervention should be performed with standard equipment using inverted maneuvers and radiographic projections.
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Affiliation(s)
- Giacomo Viggiani
- Technical University of Munich (TUM)MunichGermany
- Klinikum Rechts der Isar, Klinik und Poliklinik für Innere Medizin IMunichGermany
| | - Tareq Ibrahim
- Technical University of Munich (TUM)MunichGermany
- Klinikum Rechts der Isar, Klinik und Poliklinik für Innere Medizin IMunichGermany
| | - Julia Allescher
- Technical University of Munich (TUM)MunichGermany
- Klinikum Rechts der Isar, Klinik und Poliklinik für Innere Medizin IMunichGermany
| | - Alexander Steger
- Technical University of Munich (TUM)MunichGermany
- Klinikum Rechts der Isar, Klinik und Poliklinik für Innere Medizin IMunichGermany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart AllianceMunichGermany
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5
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Shahani R, Ahmed A, Rosell FM, Iribarne A. Coronary Artery Bypass Grafting in a Patient With Multivessel Disease and Dextrocardia With Situs Inversus Totalis. Tex Heart Inst J 2024; 51:e238382. [PMID: 38623731 DOI: 10.14503/thij-23-8382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Dextrocardia with situs inversus totalis is a rare hereditary condition characterized by reversed orientation of the major thoracic and abdominal organs. Though dextrocardia itself is not believed to increase the risk of coronary artery disease, the workup and surgical management of patients with this condition may be technically challenging to heart team clinicians. This report describes the case management of a high-risk 56-year-old man with dextrocardia who presented with multivessel coronary artery disease.
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Affiliation(s)
- Rohit Shahani
- Northwell Health, New Hyde Park, New York
- Northwell Health, Staten Island University Hospital Heart Institute, Staten Island, New York
- Department of Cardiothoracic Surgery, Staten Island University Hospital Heart Institute, Staten Island, New York
| | - Adham Ahmed
- Northwell Health, New Hyde Park, New York
- City University of New York School of Medicine, New York, New York
| | - Frank M Rosell
- Northwell Health, New Hyde Park, New York
- Northwell Health, Staten Island University Hospital Heart Institute, Staten Island, New York
- Department of Cardiothoracic Surgery, Staten Island University Hospital Heart Institute, Staten Island, New York
| | - Alexander Iribarne
- Northwell Health, New Hyde Park, New York
- Northwell Health, Staten Island University Hospital Heart Institute, Staten Island, New York
- Department of Cardiothoracic Surgery, Staten Island University Hospital Heart Institute, Staten Island, New York
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6
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Munshi SK, Jones C, Dhannapuneni R. Modified Senning procedure in a patient with dextrocardia with left atrial isomerism and anomalous systemic venous drainage: a rare case report. Cardiol Young 2024:1-5. [PMID: 38506056 DOI: 10.1017/s1047951124000477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
The atrial switch procedure by Senning or Mustard technique primarily aims in correcting parallel systemic and pulmonary circulations at atrial level. This procedure may be used in late presenting D-transposition of great arteries with a deconditioned left ventricle, congenitally corrected transposition of great arteries and isolated ventricular inversion. We describe the case of a child with dextrocardia, left atrial isomerism with complex pulmonary and systemic venous drainage resulting in mixing at atrial level. She was successfully operated by modified Senning procedure performed through the left-sided atrium.
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Affiliation(s)
- Sayar Kumar Munshi
- Department of Paediatric Cardiac Surgery, Alder Hey Children's Hospital, Liverpool, UK
| | - Caroline Jones
- Department of Paediatric Cardiology, Alder Hey Children's Hospital, Liverpool, UK
| | - Ramana Dhannapuneni
- Department of Paediatric Cardiac Surgery, Alder Hey Children's Hospital, Liverpool, UK
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7
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Kelley BP, Glasco S, Sang CJ, Yoo B, Yeung M, Zhang J. To flip or not: Case series of coronary angioplasty in patients with right-sided heart. Catheter Cardiovasc Interv 2024; 103:565-569. [PMID: 38344889 DOI: 10.1002/ccd.30973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/13/2023] [Accepted: 02/03/2024] [Indexed: 03/19/2024]
Abstract
Coronary angioplasty in patients with a right-sided heart may be difficult due to challenges in engaging the coronary arteries, interpreting angiogram, and further delivering intracoronary therapies. We present our experience of percutaneous coronary intervention in two cases and propose a practical algorithm to approach cardiac catheterization in these patients.
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Affiliation(s)
- Brian P Kelley
- Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shanice Glasco
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Charlie J Sang
- Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Bianca Yoo
- Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michael Yeung
- Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jiandong Zhang
- Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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8
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Jamil SF, Alsalahi EH, Alamri AA, Alsaman MA. Bronchial Asthma With Scimitar Syndrome: A Case Report. Cureus 2024; 16:e51823. [PMID: 38192526 PMCID: PMC10772306 DOI: 10.7759/cureus.51823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 01/10/2024] Open
Abstract
Scimitar syndrome is a rare congenital cardiopulmonary anomaly; it is also called venolobar syndrome, hypogenic lung syndrome, and Halasz syndrome. The syndrome is characterized by cardiac dextroposition, right lung and pulmonary artery hypoplasia as well as complete or partial anomalous pulmonary venous drainage of the right lung. We report a case of a 22-month-old full-term male child with a severe form of scimitar syndrome diagnosed at birth. The X-ray demonstrated dextrocardia and right lung hypoplasia, while the echocardiography clearly illustrated the scimitar vein. The patient had multiple ER visits and hospitalizations due to asthma exacerbation that was aggravated by recurrent respiratory tract infections; he responded well to asthma medications during his admissions yet compliance to his prophylactic asthma medications was poor at home.
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Affiliation(s)
- Syed F Jamil
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research, King Abdullah International Medical Research Center, Riyadh, SAU
- Pedaitrics, King Abdullah Specialized Children's Hospital, Riyadh, SAU
| | - Elham H Alsalahi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abaad A Alamri
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Majd A Alsaman
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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9
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Franqui-Rios N, Garcia Y, Velazquez-Garcia L. Dextrocardia with Situs Solitus in a Neonate - an Overview. Arch Clin Cases 2023; 10:171-174. [PMID: 38098698 PMCID: PMC10719987 DOI: 10.22551/2023.41.1004.10268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Dextrocardia, a rare congenital heart condition, can occur in about 1 out of every 12,000 pregnancies. Dextrocardia with situs solitus refers to when the heart is on the right side of the thorax while other viscera are found in their normal positions. The condition can go unnoticed in cases of limited prenatal care and newborn evaluation, leading to patients never receiving pertinent cardiac evaluations and condition progression monitoring throughout their lives. This is the first case reported of isolated dextrocardia with situs solitus in a neonate without any additional cardiovascular abnormalities. This case report highlights the importance of prenatal and postnatal evaluation to ensure the identification of neonates with dextrocardia and improve their quality of life and outcomes.
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Affiliation(s)
| | - Yasmin Garcia
- Ponce Health Sciences University, Ponce, Puerto Rico
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10
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Zou F, Flomenbaum D, Chowdhuri N, Grupposo V, Di Biase L, Zhang X. Radiofrequency ablation of persistent atrial fibrillation in a patient with situs inversus totalis and interrupted inferior vena cava. J Cardiovasc Electrophysiol 2023; 34:2621-2625. [PMID: 37987539 DOI: 10.1111/jce.16136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Catheter ablation of atrial fibrillation (AF) has emerged as the most effective therapy. However, rare anatomical abnormalities such as situs inversus totalis, dextrocardia, or interrupted inferior vena cava can make ablation challenging. METHODS AND RESULTS We report a case of a 55-year-old woman with situs inversus totalis, dextrocardia, surgical atrial septal defect repair, left-sided dual chamber pacemaker in place, and symptomatic recurrent persistent AF who underwent successful pulmonary vein and posterior wall isolation by the superior access from the left internal jugular vein. CONCLUSIONS It is a feasible and safe approach with support of transesophageal echocardiography and multiple emerging technologies.
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Affiliation(s)
- Fengwei Zou
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - David Flomenbaum
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Nilarun Chowdhuri
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Luigi Di Biase
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Xiaodong Zhang
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
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11
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Mondal S, Raj R R, Gopalakrishnan A, Harikrishnan S. Scimitar syndrome with hemi-cor triatriatum. Acta Cardiol 2023; 78:1136-1137. [PMID: 37470444 DOI: 10.1080/00015385.2023.2232690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/28/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Sudipta Mondal
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Richard Raj R
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Arun Gopalakrishnan
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Sivadasanpillai Harikrishnan
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
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12
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Nomura A, Otani N, Kokubun A, Mizuguchi S, Kawamoto S, Tomoe T, Kitahara K, Sugiyama T, Horie Y, Sugimura H, Yasu T. Successful Transvenous Implantation of a Permanent Pacemaker in a Patient with Situs Inversus with Dextrocardia Supported by Preceding Three-dimensional Computed Tomography: A Case Report. Intern Med 2023:2558-23. [PMID: 37952954 DOI: 10.2169/internalmedicine.2558-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
We herein report a 76-year-old woman with situs inversus and dextrocardia who underwent pacemaker implantation for sick sinus syndrome. Situs inversus with dextrocardia, which is frequently associated with cardiovascular malformation, is a rare congenital malformation wherein the thoracic and abdominal viscera are inverted compared with their normal positions. This renders the implantation of cardiac devices an arduous task. We therefore decided to gather preoperative anatomical information on patients with situs inversus and dextrocardia. We used three-dimensional computed tomography to collect preoperative information in order to facilitate the safe implantation of cardiac devices.
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Affiliation(s)
- Aina Nomura
- Department of Emergency and Critical Care Medicine, Dokkyo Medical University, Japan
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Japan
| | - Naoyuki Otani
- Department of Cardiology, Dokkyo Medical University Nikko Medical Center, Japan
| | - Atsuhiko Kokubun
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Japan
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Japan
| | - Satoshi Mizuguchi
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Japan
| | - Shun Kawamoto
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Japan
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Japan
| | - Takashi Tomoe
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Japan
| | - Keijiro Kitahara
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Japan
| | - Takushi Sugiyama
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Japan
| | - Yasuto Horie
- Department of Cardiology, Dokkyo Medical University Nikko Medical Center, Japan
| | - Hiroyuki Sugimura
- Department of Cardiology, Dokkyo Medical University Nikko Medical Center, Japan
| | - Takanori Yasu
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Japan
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13
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Okan T, Topaloglu C, Kucuk O, Bayraktaroglu S, Ceylan N. Coronary artery bypass grafting in a patient with situs inversus totalis. Cardiovasc J Afr 2023; 34:1-4. [PMID: 37906441 DOI: 10.5830/cvja-2023-051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023] Open
Abstract
Situs inversus totalis (SIT) describes a complete mirror image of the visceral organs in the thoracic and abdominal cavities. Dextrocardia, in combination with SIT, is a rare congenital anomaly with a frequency of 1:10 000, and coronary heart disease may occur with a similar frequency and manifestation as in the general population. Coronary computed tomography (CT) angiography is useful for accurately assessing the coronary artery origin and position for preprocedural planning of difficult coronary artery catheterisation in SIT. In this case, invasive coronary angiography (ICA) was performed from the same angle but on the opposite side compared to standard angiography. With the use of volume-rendered three-dimensional and curved reformatted images reconstructed from coronary CT angiography, the advancement of guidewires and catheters during ICA as well as the planning of surgical procedures can be performed more safely.
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Affiliation(s)
- Taha Okan
- Cardiology Department, Kardiya Medical Center, Izmir, Turkey.
| | - Caner Topaloglu
- Cardiology Department, Izmir Economy University, Izmir, Turkey
| | - Orhan Kucuk
- Radiology Department, Ege University, Izmir, Turkey
| | | | - Naim Ceylan
- Radiology Department, Ege University, Izmir, Turkey
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14
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Demirtola Aİ, İnan D, Pamuk Ö, Tugrul S, Mammadli A, Kılıçgedik A. 3D TEE imaging in a patient with severe tricuspid regurgitation with dextrocardia and tricuspid commissural prolapse. Echocardiography 2023; 40:1112-1116. [PMID: 37646446 DOI: 10.1111/echo.15678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023] Open
Abstract
Although dextrocardia is a rare congenital anomaly, it may be accompanied by numerous pathologies. Tricuspid valve prolapse is an extremely uncommon cause of primary tricuspid valve disease, as is its association with dextrocardia. In this instance, we wished to share our knowledge of tricuspid commissural prolapse together with dextrocardia, which we augmented with 3D images.
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Affiliation(s)
- Ayşe İrem Demirtola
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Duygu İnan
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Özlem Pamuk
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Sevil Tugrul
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Anar Mammadli
- Department of Cardiology, Bayindir Sogutozu Hospital, Ankara, Turkey
| | - Alev Kılıçgedik
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
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15
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Emral HG, Kamali H, Guzeltas A, Haydin S. Situs inversus with dextrocardia and transposition of great arteries. Cardiol Young 2023; 33:2130-2132. [PMID: 37309194 DOI: 10.1017/s1047951123001464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Transposition of the great arteries with left ventricle outflow tract obstruction in combination with situs inversus totalis and dextrocardia is a very rare anomaly and carries high morbidity and mortality. Only few cases have been reported with this anomaly. We describe a 21-day of infant girl with transposition of the great arteries and mirror image dextrocardia and pulmonary stenosis who underwent successful neonatal arterial switch operation and left ventricle outflow tract obstruction resection following PDA stent implantation.
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Affiliation(s)
- Hicran Gül Emral
- Pediatric Cardiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Hacer Kamali
- Pediatric Cardiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Alper Guzeltas
- Pediatric Cardiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sertac Haydin
- Pediatric Cardiac Surgery, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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16
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Shiga T, Kamiya Y, Ohkubo M, Miyamoto T, Kakinuma Y, Kayanuma H, Aoki T, Fujii Y, Aihara N, Kamiie J. Cor triatriatum sinister with dextrocardia in association with ostium secundum atrial septal defect, subpulmonary ventricular septal defect and bicuspid pulmonary valve in a pig. J Comp Pathol 2023; 206:13-16. [PMID: 37742448 DOI: 10.1016/j.jcpa.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/09/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023]
Abstract
Necropsy of a 52-day-old Camborough pig revealed numerous cardiac malformations. The positional relationship of the atria, ventricles and great vessels was a mirror image type (I, L and L): inverted arrangement of the atria, with a left-sided right atrium and right-sided left atrium (situs inversus); inverted arrangement of the ventricles, with a left-sided morphological right ventricle and right-sided morphological left ventricle (L-loop); and aortic valve to the front left relative to the pulmonary valve (L-malposed). The major malformations included an ostium secundum atrial septal defect, cor triatriatum sinister (CTS), a subpulmonary ventricular septal defect and a bicuspid pulmonary valve. Histological examination revealed myocyte hypertrophy, focal myocardial necrosis and calcification in the left morphological right ventricle of the heart. To the best of our knowledge, this is the first report of CTS in pigs. Although the individual malformations found in the present case are not unique, an unusual combination of these cardiac malformations has not been described in animals.
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Affiliation(s)
- Takanori Shiga
- Laboratory of Veterinary Pathology, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-city, Kanagawa, Japan
| | - Yumiko Kamiya
- Laboratory of Veterinary Pathology, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-city, Kanagawa, Japan
| | - Mitsuharu Ohkubo
- Hogvet Creation Inc., 1-4-14 Sendamachi, Naka-ku, Hiroshima City, Hiroshima, Japan
| | | | - Yoko Kakinuma
- Laboratory of Veterinary Pathology, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-city, Kanagawa, Japan
| | - Hideki Kayanuma
- Laboratory of Veterinary Radiology, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-city, Kanagawa, Japan
| | - Takuma Aoki
- Laboratory of Veterinary Surgery, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-city, Kanagawa, Japan
| | - Yoko Fujii
- Laboratory of Veterinary Surgery, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-city, Kanagawa, Japan
| | - Naoyuki Aihara
- Laboratory of Veterinary Pathology, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-city, Kanagawa, Japan
| | - Junichi Kamiie
- Laboratory of Veterinary Pathology, School of Veterinary Medicine, Azabu University, 1-17-71 Fuchinobe, Chuo-ku, Sagamihara-city, Kanagawa, Japan.
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17
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Nie J, Tang T, Wang Z, Zhang D, Wei J, Sheng W. Mitral valve repair in patients with mirror-image dextrocardia and situs inversus: two cases and a review of the literature. J Int Med Res 2023; 51:3000605231189129. [PMID: 37548409 PMCID: PMC10408350 DOI: 10.1177/03000605231189129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
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.
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Affiliation(s)
| | | | | | - Dafa Zhang
- Department of Cardiothoracic Surgery, First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, China
| | - Jun Wei
- Department of Cardiothoracic Surgery, First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, China
| | - Weiyong Sheng
- Department of Cardiothoracic Surgery, First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, China
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18
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Shakir A, Dominic P, Amorn A, Kasabali B. Wide Complex Tachycardia in a Right-Sided Heart: Diagnostic and Therapeutic Challenges. JACC Case Rep 2023; 18:101922. [PMID: 37545685 PMCID: PMC10401125 DOI: 10.1016/j.jaccas.2023.101922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 08/08/2023]
Abstract
Dextroposition is a rare cardiac malformation defined as heart shift to right of midline. ECG findings vary with degree of displacement within the chest cavity. We report the second known case of dextroposition with accessory pathway (posteroseptal in our patient), presenting as pre-excited atrial tachycardia. Abnormal anatomy complicates pathway localization/ablation. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Aamina Shakir
- Louisiana State University Health Sciences Center—Shreveport, Shreveport, Louisiana, USA
| | - Paari Dominic
- University of Iowa Health Care, Iowa City, Iowa, USA
| | - Allen Amorn
- Cincinnati VA Medical Center, Cincinnati, Ohio, USA
| | - Basel Kasabali
- Willis-Knighton Medical Center, Shreveport, Louisiana, USA
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19
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Nabhan EM, Bechara T. Isolated Dextrocardia With Situs Solitus Diagnosed in a Centenarian Patient: A Case Report. Cureus 2023; 15:e42686. [PMID: 37649931 PMCID: PMC10464863 DOI: 10.7759/cureus.42686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2023] [Indexed: 09/01/2023] Open
Abstract
This case report presents a rare instance of dextrocardia with situs solitus in a centenarian patient, where the heart is abnormally positioned on the right side of the chest due to embryological development anomalies. The patient, a 102-year-old male with no significant medical history, sought medical attention for cataract surgery and was incidentally found to have a systolic murmur over the left upper sternal border, prompting further evaluation. Echocardiographic assessments revealed moderate aortic stenosis. Further imaging with an upright chest X-ray confirmed the presence of dextrocardia with situs solitus. This intriguing case exemplifies the complexities of diagnosing rare congenital anomalies and underscores the importance of comprehensive evaluations even in elderly patients.
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Affiliation(s)
- Elias M Nabhan
- Internal Medicine, Lebanese University Faculty of Medicine, Beirut, LBN
- Cardiology, University of Balamand, Beirut, LBN
| | - Tony Bechara
- Cardiology, Central Military Hospital, Beirut, LBN
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20
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Lim R, Bais N, Ali F, Monsalve R, Denney B. Right Heart and Wrong Rhythm: Atrial Flutter in Dextrocardia. Cureus 2023; 15:e42177. [PMID: 37602138 PMCID: PMC10439519 DOI: 10.7759/cureus.42177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Atrial flutter is characterized by rapid atrial activity, causing an abnormal heart rhythm. Recognition and prompt management are of utmost importance since this cardiac arrhythmia could increase the risk of thromboembolic stroke and atrial fibrillation, which may lead to disability and death. Risk factors include myocardial infarction, surgery, medication, and structural heart abnormalities. One distinctive structural abnormality is dextrocardia. Herein, we present a case of a 47-year-old male who initially complains of difficulty in ambulation. Further workup showed atrial flutter with rapid ventricular response on electrocardiogram (ECG) and dextrocardia on imaging. This case tackles the possible association between dextrocardia and arrhythmias, which was an atrial flutter, its management, and treatment outcomes.
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Affiliation(s)
- Roy Lim
- Internal Medicine, Mount Sinai Hospital, Chicago, USA
| | - Navdeep Bais
- Medicine, Ross University School of Medicine, Miramar, USA
| | - Furkhan Ali
- Internal Medicine, Mount Sinai Hospital, Chicago, USA
| | - Reejeen Monsalve
- Internal Medicine, Our Lady of Fatima University, Valenzeula, PHL
| | - Brian Denney
- General Medicine, Cebu Velez General Hospital, Cebu City, PHL
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21
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Al Jabran HA, Alnahawi M, Alhaddad MJ. Gastric Cancer With Situs Inversus Totalis: A Case Report With More Than Five Years of Follow-Up. Cureus 2023; 15:e39512. [PMID: 37366445 PMCID: PMC10290745 DOI: 10.7759/cureus.39512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/28/2023] Open
Abstract
In Saudi Arabia, gastric cancer is a major health burden, ranking as the thirteenth most common cancer type. Situs inversus totalis (SIT), which is a very rare congenital anomaly, refers to a completely reversed location of the abdominal and thoracic organs (mirror image of the normal). Here, we present the first reported case of gastric cancer in an SIT patient in Saudi Arabia and the Gulf Cooperation Council (GCC) countries, and highlight the challenges faced by the surgical team in the removal of such cancer in this patient population.
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Affiliation(s)
| | | | - Mousa J Alhaddad
- Department of Internal Medicine, Dammam Medical Complex, Dammam, SAU
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22
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Rao PS. Therapy of Patients with Cardiac Malposition. Children (Basel) 2023; 10:children10040739. [PMID: 37189988 DOI: 10.3390/children10040739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/31/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023]
Abstract
Positional abnormalities per se do not require treatment, but in their place, the accompanying pulmonary pathology in dextroposition patients and pathophysiologic hemodynamic abnormalities resulting from multiple defects in patients with cardiac malposition should be the focus of treatment. At the time of the first presentation, treating the pathophysiologic aberrations caused by the defect complex, whether it is by improving the pulmonary blood flow or restricting it, is the first step. Some patients with simpler or single defects are amenable to surgical or transcatheter therapy and should be treated accordingly. Other associated defects should also be treated appropriately. Biventricular or univentricular repair dependent on the patient's cardiac structure should be planned. Complications in-between Fontan stages and after conclusion of Fontan surgery may occur and should be promptly diagnosed and addressed accordingly. Several other cardiac abnormalities unrelated to the initially identified heart defects may manifest in adulthood, and they should also be treated.
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Affiliation(s)
- P Syamasundar Rao
- Children's Heart Institute, Children's Memorial Hermann Hospital, McGovern Medical School, University of Texas-Houston, 6410 Fannin Street, UTPB Suite # 425, Houston, TX 77030, USA
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23
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Angellotti D, Esposito G, Piccolo R. Double Inversion Technique for Multivessel Primary PCI in Dextrocardia. JACC Cardiovasc Interv 2023; 16:868-869. [PMID: 37045507 DOI: 10.1016/j.jcin.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 01/03/2023] [Indexed: 04/14/2023]
Affiliation(s)
- Domenico Angellotti
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Raffaele Piccolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
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24
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Afzal I, Rahman S, Syed F, Hai O, Zeltser R, Makaryus AN. Transient Ischemic Attack in a Patient With Poland Syndrome With Dextrocardia. Cureus 2023; 15:e38185. [PMID: 37252545 PMCID: PMC10220516 DOI: 10.7759/cureus.38185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
This report discusses the case of a patient with a past medical history of Poland syndrome and dextrocardia who was admitted for a transient ischemic attack. Poland syndrome is a rare genetic condition characterized by underdevelopment of chest wall musculature that presents with a variety of associations that may or may not be present in each case. This case report intends to discuss a unique presentation of Poland syndrome with dextrocardia, one of the rare conditions associated with Poland syndrome, as well as the treatment of Poland syndrome as a whole and possible associated complications.
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Affiliation(s)
- Iraj Afzal
- Internal Medicine, Nassau University Medical Center, East Meadow, USA
| | - Samin Rahman
- Internal Medicine, Nassau University Medical Center, East Meadow, USA
| | - Faiz Syed
- Internal Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, USA
| | - Ofek Hai
- Cardiology, Nassau University Medical Center, East Meadow, USA
| | - Roman Zeltser
- Cardiology, Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA
- Cardiology, Nassau University Medical Center, East Meadow, USA
| | - Amgad N Makaryus
- Cardiology, Northwell Health, Manhasset, USA
- Cardiology, Nassau University Medical Center, East Meadow, USA
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25
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M VB, Vaddavalli VV, Abuji K, Palle P, Ramavath K. Two Surgeons' Technique for Laparoscopic Cholecystectomy in Situs Inversus for a Right-Handed Surgeon: Technical and Ergonomic Considerations. Cureus 2023; 15:e38161. [PMID: 37252533 PMCID: PMC10219618 DOI: 10.7759/cureus.38161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 05/31/2023] Open
Abstract
Laparoscopic cholecystectomy can be technically challenging in patients with situs inversus totalis. A middle-aged gentleman presented with pain in the left upper abdomen. His cardiac workup showed dextrocardia, and ultrasonography showed a gall bladder on the left side. He was diagnosed with acute cholecystitis and was planned for laparoscopic cholecystectomy. We used the four-port technique, where anterior dissection was carried out by the dominant right hand of the primary surgeon, and the infundibulum was retracted by the first assistant from the mid-clavicular port. The first assistant carried out the posterior dissection through a midclavicular port, whereas the primary surgeon did a retraction. To conclude, this technique done by two surgeons decreases the ergonomic difficulty faced by right-handed surgeons while performing laparoscopic cholecystectomy.
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Affiliation(s)
- Venu Bhargava M
- Department of Surgical Gastroenterology, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Hyderabad, IND
| | - Venkata Vineeth Vaddavalli
- Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Kishore Abuji
- Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Pranay Palle
- Department of General Surgery, Gandhi Medical College and Hospital, Hyderabad, IND
| | - Krishna Ramavath
- Department of General Surgery, All India Institute of Medical Sciences, Hyderabad, IND
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26
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Muacevic A, Adler JR, Ferraro B, Durkin M, Krinock M, Durkin M. A Rare Case of ST-Segment Elevation Myocardial Infarction and Left Ventricular Thrombus in a Dextrocardia Patient With COVID-19 Infection. Cureus 2023; 15:e33527. [PMID: 36779150 PMCID: PMC9906126 DOI: 10.7759/cureus.33527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2023] [Indexed: 01/11/2023] Open
Abstract
Acute coronary syndrome (ACS) is an increasingly common finding among patients presenting with Coronavirus Disease 2019 (COVID-19) pneumonia. While cardiovascular disease alone remains one of the most common causes of death among COVID-19 patients in the United States, its heightened prevalence with COVID-19 pneumonia has been well documented. Here we present the case of a 58-year-old male with an extensive cardiac history including coronary artery disease (CAD) with multiple drug-eluting stents (DES) placed and an episode of cardiac arrest requiring implantable cardioverter defibrillator (ICD) placement. He presented to the Emergency Department originally complaining of chest pain, shortness of breath, and fatigue, and was found to be positive for COVID-19 pneumonia. Cardiac catheterization demonstrated extensive CAD and evaluation for coronary artery bypass grafting (CABG) was warranted. Shortly after, the patient experienced an acute thrombotic episode in the left anterior descending (LAD) coronary artery and underwent successful emergent high-risk percutaneous coronary intervention (PCI) with DES placement. The patient was also found to have a left ventricular thrombus requiring anticoagulation. Despite his complex course, the patient had a very favorable outcome.
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27
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Bontempi L, Fundaliotis A, Moretti M, Sammartino AM, Saino AT, Arabia G, Pitì A, Curnis A, Dell'Aquila A. Leadless pacemaker implantation in dextrocardia with situs viscerum inversus: A case report and literature review. Pacing Clin Electrophysiol 2023; 46:39-43. [PMID: 35941725 DOI: 10.1111/pace.14579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/28/2022] [Accepted: 08/05/2022] [Indexed: 01/20/2023]
Abstract
Leadless pacemaker implantation (LPI) has fewer device complications and reduced chance of infection compared to conventional pacemakers. Dextrocardia with situs viscerum inversus (DC+SVI) is a rare condition, which seldom leads to cardiac complications. However, its presence poses a challenge to operators in cardiac procedures. LPI reports in DC patients are scarce. We report a case of LPI in a DC+SVI patient, followed by a brief but comprehensive literature review.
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Affiliation(s)
- Luca Bontempi
- Unit of Cardiology, Cardiac Electrophysiology and, Electrostimulation Laboratory, "Bolognini" Hospital of Seriate - ASST Bergamo Est, Bergamo, Italy.,Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Institute of Cardiology, ASST Spedali Civili Hospital of Brescia and University of Brescia, Brescia, Italy
| | - Angelica Fundaliotis
- Unit of Cardiology, Cardiac Electrophysiology and, Electrostimulation Laboratory, "Bolognini" Hospital of Seriate - ASST Bergamo Est, Bergamo, Italy
| | - Marina Moretti
- Unit of Cardiology, Cardiac Electrophysiology and, Electrostimulation Laboratory, "Bolognini" Hospital of Seriate - ASST Bergamo Est, Bergamo, Italy
| | - Antonio Maria Sammartino
- Unit of Cardiology, Cardiac Electrophysiology and, Electrostimulation Laboratory, "Bolognini" Hospital of Seriate - ASST Bergamo Est, Bergamo, Italy.,Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Institute of Cardiology, ASST Spedali Civili Hospital of Brescia and University of Brescia, Brescia, Italy
| | - Antonio Tommaso Saino
- Unit of Cardiology, Cardiac Electrophysiology and, Electrostimulation Laboratory, "Bolognini" Hospital of Seriate - ASST Bergamo Est, Bergamo, Italy
| | - Gianmarco Arabia
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Institute of Cardiology, ASST Spedali Civili Hospital of Brescia and University of Brescia, Brescia, Italy
| | - Antonino Pitì
- Unit of Cardiology, Cardiac Electrophysiology and, Electrostimulation Laboratory, "Bolognini" Hospital of Seriate - ASST Bergamo Est, Bergamo, Italy
| | - Antonio Curnis
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Institute of Cardiology, ASST Spedali Civili Hospital of Brescia and University of Brescia, Brescia, Italy
| | - Andrea Dell'Aquila
- Unit of Cardiology, Cardiac Electrophysiology and, Electrostimulation Laboratory, "Bolognini" Hospital of Seriate - ASST Bergamo Est, Bergamo, Italy.,Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Institute of Cardiology, ASST Spedali Civili Hospital of Brescia and University of Brescia, Brescia, Italy
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28
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Rao PS, Rao NS. Diagnosis of Dextrocardia with a Pictorial Rendition of Terminology and Diagnosis. Children (Basel) 2022; 9. [PMID: 36553425 DOI: 10.3390/children9121977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/04/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
A significant number of patients with dextrocardia and other cardiac malpositions have other congenital heart defects (CHDs). The incidence of CHDs in subjects with cardiac malpositions is significantly greater than that in normal children, and the prevalence varies with the associated visceroatrial situs. The most useful approach to diagnosis is segmental analysis. Firstly, dextroposition should be excluded. In segmental analysis, the visceroatrial situs, ventricular location, status of atrioventricular connections, the great artery relationship, and conotruncal relationship are determined with the use of electrocardiogram (ECG), chest X-ray, and echocardiographic studies, and, when necessary, other imaging studies, including angiography. Following identification of the afore-mentioned segments, the associated defects in the atrial and ventricular septae, valvar and vascular stenosis or atresia may be determined by a review of the historical information, physical examination, and analysis of chest roentgenogram, ECG, and echocardiographic studies. Along the way, a pictorial rendition of the terminology and diagnosis of cardiac malpositions is undertaken.
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29
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Fujita T, Yoshida A, Ichikawa M. A case report of paroxysmal complete atrioventricular block in a patient with dextrocardia and repaired tetralogy of Fallot. Eur Heart J Case Rep 2022; 6:ytac428. [PMID: 36405537 PMCID: PMC9671030 DOI: 10.1093/ehjcr/ytac428] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/24/2022] [Accepted: 10/26/2022] [Indexed: 01/14/2024]
Abstract
BACKGROUND Some adults suffer sudden cardiac death after previous surgical repair of tetralogy of Fallot (TOF), and in such cases, ventricular tachycardia is believed to be the most frequent cause of death. However, we report a case of cardiac arrest due to paroxysmal complete atrioventricular block in an adult with dextrocardia and repaired TOF. CASE SUMMARY A 49-year-old woman with dextrocardia and a history of surgical treatment for TOF lost consciousness three times. A previously implanted loop recorder showed a 60-second cardiac arrest, and complete atrioventricular block was diagnosed. An electrophysiological study showed prolongation of the His-ventricular interval but no ventricular tachycardia. A dual chamber pacemaker was implanted, and there has been no recurrence of syncope in the 23 months since implantation. DISCUSSION There is little evidence for paroxysmal complete atrioventricular block in patients with repaired TOF. This case suggests that paroxysmal complete atrioventricular block can occur late after surgical repair of TOF, and research needs to elucidate whether it is the cause of sudden cardiac death in some patients with TOF.
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Affiliation(s)
- Takeshi Fujita
- Department of Cardiology, Higashi-Osaka Medical Center, 3-4-5 Nishi-Iwata, Higashiosaka, Osaka, 578-8588Japan
| | - Akira Yoshida
- Department of Cardiology, Higashi-Osaka Medical Center, 3-4-5 Nishi-Iwata, Higashiosaka, Osaka, 578-8588Japan
| | - Minoru Ichikawa
- Department of Cardiology, Higashi-Osaka Medical Center, 3-4-5 Nishi-Iwata, Higashiosaka, Osaka, 578-8588Japan
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30
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Yusuf Ali A, Biyikli A, Abdi AM, Guler I. Infantile Bowel Obstruction in a Patient with Situs Inversus Totalis and Polysplenia: A Case Report. Int Med Case Rep J 2022; 15:605-609. [PMID: 36330372 PMCID: PMC9624170 DOI: 10.2147/imcrj.s385808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/19/2022] [Indexed: 01/24/2023] Open
Abstract
The infantile intestinal obstruction associated with situs inversus totalis and polysplenia is extremely rare, with only a few cases reported in the literature. Furthermore, the management of this association is complicated. We report a case of a 2-month-old boy with intestinal obstruction due to malrotation and volvulus with thin translucent omentum sac encasing the small intestine associated with situs inversus totalis, polysplenia, and pulmonary hypertension. To the best of our knowledge, this is the first case of situs inversus totalis with polysplenia, pulmonary hypertension, and intestinal obstruction due to malrotation and volvulus with thin translucent omentum sac encasing the small intestine.
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Affiliation(s)
- Abdullahi Yusuf Ali
- Department of Pediatric Surgery, Somalia Turkish Training and Research Hospital, Mogadishu, Somalia,Correspondence: Abdullahi Yusuf Ali, Tel +252615474485, Email
| | - Ahmet Biyikli
- Department of Pediatric Surgery, Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Abdishakur Mohamed Abdi
- Department of Pediatric Surgery, Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Ilkay Guler
- General Directorate of Public Hospitals, Ministry of Health of Republic of Turkiye, Ankara, Turkey
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Basgoze S, Temur B, Guvenc O, Aydin S, Guzelmeric F, Onalan MA, Erek E. Analysis of outcomes in patients with abnormal laterality undergoing congenital heart surgery. Cardiol Young 2022; 32:1129-35. [PMID: 34593080 DOI: 10.1017/S1047951121003899] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Laterality anomalies are almost always associated with severe cardiac anomalies. Demographic properties, type of the procedures, associated anomalies, and early and mid-term prognosis of four types of laterality anomalies were analysed. METHODS A total of 64 consecutive patients with laterality anomalies were enrolled between July 2014 and July 2020. We grouped the patients as situs solitus dextrocardia (SSD) (n = 12; 18.7%); situs inversus (SI) (n = 16; 25%); right atrial isomerism (RAI) (n = 29; 45.3%); and left atrial isomerism (LAI) (n = 7; 10.9%). TAPVC was only present in the RAI group (31%). Incidence of mitral or tricuspid atresia was higher in the SSD group (25%). All the patients were followed up with a mean of 19.06 ± 17.6 (0.1-72) months. RESULTS Early postoperative mortality was 17 patients, among 107 procedures (15.8%). Twelve patients were in the neonatal period. All ten patients survived after isolated ductal stenting. Fourteen of the deaths were in the RAI group (48.3%). The 3-year survival rates were 85% in LAI, 78.7% in SI, 55.8% in SSD, and 38% in RAI groups. According to the multivariable Cox regression model, mechanical ventilation, kidney injury, RAI, and complex surgery in the neonatal period were independent risk factors for early mortality. CONCLUSION Laterality anomalies are one of the most challenging patients who commonly had univentricular physiology. The most prevalent anomaly was RAI, and RAI had the worst outcome and survival. Ductal stent is an acceptable first intervention during the neonatal period in suitable patients. Complex procedures may carry a high risk of death in the neonatal period.
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Motaganahalli AR, Wang SK, Sawchuk AP. Endovascular Repair of an Intrathoracic Subclavian Artery Aneurysm in a Patient With Dextrocardia. Vasc Endovascular Surg 2022; 57:69-74. [PMID: 35675973 DOI: 10.1177/15385744221108045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
| | - S Keisin Wang
- 12339University of Texas Health Sciences Center, Houston, TX, USA
| | - Alan P Sawchuk
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
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Fabrizio R, Francesco R, Michele D, Lorenzo DB, Antonio C, Claudio M, Stefano B. Thoracoscopic AF ablation in situs inversus dextrocardia with interrupted inferior vena cava continuation in azygos vein. J Card Surg 2022; 37:2446-2449. [PMID: 35637597 PMCID: PMC9328127 DOI: 10.1111/jocs.16619] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/23/2022] [Indexed: 11/29/2022]
Abstract
Introduction Situs inversus totalis, dextrocardia with interrupted inferior vena cava, and azygos vein continuation concomitant with symptomatic atrial fibrillation requiring ablation. This case was deemed not suitable for percutaneous ablation due to anatomic variations and the lack of case reports in the literature. Methods and Results We performed bilateral thoracoscopic epicardial ablation and epicardial left atrial appendage exclusion. The direct vision allowed for a complete box lesion set with bipolar radiofrequency device. Patient remained in sinus rhythm at the 12‐months follow‐up. Conclusion Surgical thoracoscopic epicardial ablation is safe and effective also in congenital defects. Multidisciplinary expertise can offer minimally invasive ablation treatments.
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Affiliation(s)
- Rosati Fabrizio
- Division of Cardiac Surgery, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Rattenni Francesco
- Division of Cardiac Surgery, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - D'Alonzo Michele
- Division of Cardiac Surgery, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Di Bacco Lorenzo
- Division of Cardiac Surgery, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Curnis Antonio
- Division of Electrophysiology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Muneretto Claudio
- Division of Cardiac Surgery, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Benussi Stefano
- Division of Cardiac Surgery, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
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34
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Chan DTL, Bhatia I, Lam SCC, Au TWK. Transapical transcatheter J-valve for aortic regurgitation in dextrocardia situs inversus. Asian Cardiovasc Thorac Ann 2022; 30:816-818. [PMID: 35234054 DOI: 10.1177/02184923221083723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 71-year-old lady with dextrocardia and pure aortic regurgitation was treated with transcatheter aortic valve replacement using the transapical J-valve system. Good clinical and echocardiographic results were demonstrated at one-year follow-up. Herewith we describe this simple, safe, and a minimally invasive aortic valve replacement option for this condition.
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Affiliation(s)
| | - Inderjeet Bhatia
- Department of Cardiothoracic Surgery, 26473Queen Mary Hospital, Hong Kong
| | - Simon Chi-Cheung Lam
- Division of Cardiology, Department of Medicine, 26473Queen Mary Hospital, Hong Kong
| | - Timmy Wing-Kuk Au
- Department of Cardiothoracic Surgery, 26473Queen Mary Hospital, Hong Kong
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35
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Zhang Y, Sun L, Luo F, Li J, Sun Y, Chen Y, Dong J. Result and technique consideration of radiofrequency catheter ablation of tachycardia in patients with dextrocardia. Pacing Clin Electrophysiol 2022; 45:340-347. [PMID: 35044698 DOI: 10.1111/pace.14452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/08/2022] [Accepted: 01/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with tachycardia, in the context of pre-existing dextrocardia, could benefit from catheter ablation. However, anatomical complexities hinder effective conduct of this procedure. We aimed to retrospectively summarize the clinical characteristics and the safety and efficiency, and recommended the technique considerations. METHODS Twenty-one cases from 19 patients with tachycardia and dextrocardia, who underwent catheter ablation between 2009 and 2021, were enrolled. All patients underwent echocardiography and computed tomography (CT) to confirm the anatomical malformations. Transseptal puncture was guided by fluoroscopy or intracardiac echocardiography when left atrial access was necessary and the ablation process was guided by three-dimensional mapping. RESULTS Six cases exhibited situs solitus while nine cases exhibited situs inversus. Fourteen cases had atrial fibrillation, seven had atrial flutter, and two had atrioventricular reentrant tachycardia (AVRT); two cases had combined atrial fibrillation and atrial flutter. Acute success was achieved in 18 cases (85.7%, 18/21). The three-dimensional mapping system was not employed in the three cases which failed. During long-term follow-up (20.71 ± 21.86 months), eight cases (72.7%, 8/11) of atrial fibrillation with dextrocardia successfully attained sinus rhythm. None of AVRT cases had recurrence. Half of the atrial flutter cases with dextrocardia, especially those with a history of surgical correction for cardiac malformations, underwent recurrence. One case had cardiac tamponade. CONCLUSIONS Catheter ablation for tachycardia patients with dextrocardia, is safe, efficient, and feasible. It is imperative to integrate echocardiography, cardiac computer tomography, and three-dimensional mapping, and apply three-dimensional reconstruction to facilitate the success of catheter ablation. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yuekun Zhang
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Liping Sun
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fangyuan Luo
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiaju Li
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yibo Sun
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingwei Chen
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianzeng Dong
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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36
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de Abreu CR, Paulo MR, Andretta ALDS, Baroncini LAV. Isolated dextrocardia with situs solitus in a dog - case report. Braz J Vet Med 2022; 44:e000622. [PMID: 35749064 PMCID: PMC9179193 DOI: 10.29374/2527-2179.bjvm000622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/05/2022] [Indexed: 11/11/2022] Open
Abstract
Dextrocardia with situs solitus is a rare disorder caused by embryological malformation. It may be asymptomatic and overlooked when isolated, or when it presents with different symptoms and clinical signs associated with other cardiac and extracardiac malformations. The present article describes the radiologic, electrocardiographic, and echocardiographic findings of a Pitbull dog with isolated dextrocardia and situs solitus.
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Affiliation(s)
- Cris Rangel de Abreu
- Veterinarian, Programa de Pós-graduação em Medicina Veterinária (PPGMV), Departamento de Cirurgia, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Maicon Roberto Paulo
- Veterinarian, MSc, Programa de Pós-Graduação em Ciência Animal (PPCA), Escola de Ciências Agrárias e Medicina Veterinária, Pontificia Universidade Católica do Paraná, Curitiba, PR, Brazil
| | | | - Liz Andréa Villela Baroncini
- Undegraduate in Veterinary Medicine, Universidade Positivo, Ecoville, Curitiba, PR, Brazil
- CorrespondenceLiz Andréa Villela Baroncini Universidade Positivo Rua Pedro Viriato Parigot de Souza, 5300, Campus Ecoville, CEP 81280-330, Curitiba-PR, Brasil CEP 80250-072 - Curitiba (PR), Brasil E-mail:
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37
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Zhang W, Xing W, Zhong X, Zhu M, He J. Emergency thrombectomy for cerebrovascular occlusion in a patient with mirror-image dextrocardia: a case report. J Int Med Res 2022; 50:3000605211072785. [PMID: 35023389 PMCID: PMC8793582 DOI: 10.1177/03000605211072785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/16/2021] [Indexed: 11/15/2022] Open
Abstract
Cases of patients complicated with dextrocardia who suffer from acute cerebral infarction with large vessel occlusion and receive emergency thrombectomy are particularly rare and have not been widely reported. This article aimed to increase the awareness and knowledge of these cases. We report the case of a patient with mirror-image dextrocardia who suffered from cerebral infarction with large vessel occlusion and received emergency thrombectomy. A male patient in his early 60s with dextrocardia had acute cerebral infarction with posterior circulation large vessel occlusion and underwent emergency thrombectomy. During the operation, the rapid confirmation of dextrocardia and use of flexible interventional instruments helped establish a pathway for blood flow. We used an intracranial thrombectomy stent and intracranial balloon dilation catheter to restore the cerebral blood supply. The Modified Rankin Scale score was 0 at 3 months after thrombectomy, indicating a good prognosis of the patient. Acute cerebral infarction with large vessel occlusion in patients with dextrocardia is extremely rare. Emergency thrombectomy is feasible to recanalize cerebral blood flow and give patients a chance to recover.
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Affiliation(s)
- Wensheng Zhang
- Department of Neurology, Heyuan People’s Hospital, Guangdong Provincial People’s Hospital Heyuan Hospital, Guangdong Province, China
| | - Weifang Xing
- Department of Neurology, Heyuan People’s Hospital, Guangdong Provincial People’s Hospital Heyuan Hospital, Guangdong Province, China
| | - Xiaojing Zhong
- Department of Neurology, Heyuan People’s Hospital, Guangdong Provincial People’s Hospital Heyuan Hospital, Guangdong Province, China
| | - Minzhen Zhu
- Department of Neurology, Heyuan People’s Hospital, Guangdong Provincial People’s Hospital Heyuan Hospital, Guangdong Province, China
| | - Jinzhao He
- Department of Neurology, Heyuan People’s Hospital, Guangdong Provincial People’s Hospital Heyuan Hospital, Guangdong Province, China
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38
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Alsamri MT, Alabdouli A, Iram D, Alkalbani AM, Almarzooqi AS, Souid AK, Vijayan R. A Study on the Genetics of Primary Ciliary Dyskinesia. J Clin Med 2021; 10:5102. [PMID: 34768622 DOI: 10.3390/jcm10215102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 11/16/2022] Open
Abstract
Primary ciliary dyskinesia (PCD) is a poorly understood disorder. It is primarily autosomal recessive and is prevalent in tribal communities of the United Arab Emirates due to consanguineous marriages. This retrospective study aimed to assess the pathogenicity of the genetic variants of PCD in indigenous patients with significant clinical respiratory problems. Pathogenicity scores of variants obtained from the chart review were consolidated using the Ensembl Variant Effect Predictor. The multidimensional dataset of scores was clustered into three groups based on their pathogenicity. Sequence alignment and the Jensen–Shannon Divergence (JSD) were generated to evaluate the amino acid conservation at the site of the variation. One-hundred and twelve variants of 28 genes linked to PCD were identified in 66 patients. Twenty-two variants were double heterozygous, two triple heterozygous, and seven homozygous. Of the thirteen novel variants, two, c.11839 + 1G > A in dynein, axonemal, heavy chain 11 (DNAH11) and p.Lys92Trpfs in dynein, axonemal, intermediate chain 1 (DNAI1) were associated with dextrocardia with situs inversus, and one, p.Gly21Val in coiled-coil domain-containing protein 40 (CCDC40), with absent inner dynein arms. Homozygous C1orf127:p.Arg113Ter (rs558323413) was also associated with laterality defects in two related patients. The majority of variants were missense involving conserved residues with a median JSD score of 0.747. Homology models of two deleterious variants in the stalk of DNAH11, p.Gly3102Asp and p.Leu3127Arg, revealed structural importance of the conserved glycine and leucine. These results define potentially damaging PCD variants in the region. Future studies, however, are needed to fully comprehend the genetic underpinnings of PCD.
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Al-Dairy A, Shammout R, Al Habbal R. Surgical repair of left-sided partial anomalous pulmonary venous connection associated with situs inversus totalis. Clin Case Rep 2021; 9:e04914. [PMID: 34631093 PMCID: PMC8489498 DOI: 10.1002/ccr3.4914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/07/2021] [Accepted: 09/24/2021] [Indexed: 11/19/2022] Open
Abstract
The recognition of situs inversus is of great importance to avoid possible surgical mishaps that may result from the failure to recognize reversed anatomy or an atypical history. The repair of associated PAPVC with situs inversus totalis needs special attention during surgery due to the reversed anatomy.ss.
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Affiliation(s)
- Alwaleed Al-Dairy
- Assistant Professor in Cardiac Surgery at Faculty of Medicine Damascus University Damascus Syria
| | - Reem Shammout
- Faculty of Medicine Damascus University Damascus Syria
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40
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Aizawa Y, Ichiki T, Yoshizawa A, Monma Y, Nakayama T, Kato TS, Inami S, Fujimoto Y, Kawamura A. Successful Leadless Pacemaker Implantation in an Elderly Patient With Dextrocardia and Situs Inversus. Cureus 2021; 13:e17858. [PMID: 34527500 PMCID: PMC8432435 DOI: 10.7759/cureus.17858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 11/05/2022] Open
Abstract
Leadless pacemaker is indicated in patients with symptomatic bradycardia as an alternative therapy when transvenous pacemaker implantation is considered difficult or at high risk. The experience of implanting leadless pacemaker in patients with dextrocardia and situs inversus is limited. A 94-year-old male was transferred to our hospital due to advanced atrio-ventricular block with episode of syncope. Chest radiograph and computed tomography revealed dextrocardia with situs inversus. Emergency cardiac catheterization was performed and a temporary pacemaker was inserted, but the patient removed it due to delirium. So, a leadless pacemaker was implanted to him. Shorter time of bed-rest after the implantation and shorter hospital stay would be beneficial of implanting a leadless pacemaker. Precise anatomical evaluation would be important to perform implantation efficiently and safely.
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Affiliation(s)
- Yoshiyasu Aizawa
- Cardiology, International University of Health and Welfare Narita Hospital, Narita, JPN
| | - Tomoko Ichiki
- Cardiology, International University of Health and Welfare Narita Hospital, Narita, JPN
| | - Akihiro Yoshizawa
- Cardiology, International University of Health and Welfare Narita Hospital, Narita, JPN
| | - Yuto Monma
- Cardiology, International University of Health and Welfare Narita Hospital, Narita, JPN
| | - Takashi Nakayama
- Cardiology, International University of Health and Welfare Narita Hospital, Narita, JPN
| | - Tomoko S Kato
- Cardiology, International University of Health and Welfare Narita Hospital, Narita, JPN
| | - Shigenobu Inami
- Cardiology, International University of Health and Welfare Narita Hospital, Narita, JPN
| | - Yoshihide Fujimoto
- Cardiology, International University of Health and Welfare Narita Hospital, Narita, JPN
| | - Akio Kawamura
- Cardiology, International University of Health and Welfare Narita Hospital, Narita, JPN
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Venugopal K, Chengjie L, Wee Tiong Y. Supraventricular Tachycardia in Situs Inversus Totalis and Congenitally Corrected Transposition of the Great Arteries. JACC Case Rep 2021; 3:597-602. [PMID: 34317585 PMCID: PMC8302798 DOI: 10.1016/j.jaccas.2021.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/06/2021] [Accepted: 01/22/2021] [Indexed: 11/06/2022]
Abstract
We share a rare case of an older adult patient with situs inversus totalis (mirror image of all viscera, including dextrocardia) and congenitally corrected transposition of the great arteries who presented with supraventricular tachycardia. We highlight the unique electrocardiographic characteristics of these rare conditions and the importance of electrocardiogram interpretation skills. (Level of Difficulty: Advanced.)
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Affiliation(s)
- Kuhan Venugopal
- Department of Emergency Medicine, Sengkang General Hospital, Singapore
| | - Lee Chengjie
- Department of Emergency Medicine, Sengkang General Hospital, Singapore
| | - Yeo Wee Tiong
- Department of Cardiology, National University Heart Centre, Singapore
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42
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Mehra D, Alvarado J, Diaz-Martell Y, Saavedra L, Davenport J. Recurrent Hiatal Hernia Resulting in Rightward Mediastinal Shift: Diagnostics in Cardiology and Clinical Pearls. Cureus 2021; 13:e16521. [PMID: 34306902 PMCID: PMC8294029 DOI: 10.7759/cureus.16521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/20/2021] [Indexed: 11/30/2022] Open
Abstract
On radiographic imaging, the finding of a right-sided heart location can be due to multiple etiologies and may be congenital or acquired. We present the case of a 71-year-old male with a self-reported past medical history of hiatal hernia and previously diagnosed dextrocardia. The patient experienced cardiovascular intervention following an ST-elevation myocardial infarction. In the cardiac workup, a low-voltage normal electrocardiogram confirmed dextroposition of the heart due to significant herniation of gastric contents into the thoracic cavity. This gentleman had presumably been diagnosed with dextrocardia, a right-left reversal of heart anatomy and electrophysiology, based on imaging and incomplete workup. Dextroposition refers to a rightward shift of the mediastinum with no changes in orientation of cardiac anatomy, and therefore unchanged directional orientation of conduction. This is an important distinction from dextrocardia, a mirror-image reversal of the cardiac chambers and heart location in the chest wall, such as that due to congenital ciliary dysfunction. A sliding hernia is an uncommon cause of the rightward mediastinal shift, with few such cases documented in the literature, and cardiovascular manifestations of hiatal hernias are discussed. This case exemplifies the role of an electrocardiogram in distinguishing between dextrocardia and dextroposition for accurate diagnosis and management.
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Affiliation(s)
- Divy Mehra
- Ophthalmology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Javier Alvarado
- Internal Medicine, Kendall Regional Medical Center, Kendall, USA
| | | | - Lino Saavedra
- Internal Medicine, Kendall Regional Medical Center, Kendall, USA
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43
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Relan J, V B, Kadiyani L, Hote MP, Ramakrishnan S, Kothari SS. Dextroversion due to giant left atrium in a child. Echocardiography 2021; 38:1356-1358. [PMID: 34236100 DOI: 10.1111/echo.15136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/26/2021] [Accepted: 06/01/2021] [Indexed: 11/26/2022] Open
Abstract
Giant left atrium is extremely rare in pediatric population. We hereby report a case of 4-year-old child with giant left atrium (LA) due to "non-rheumatic" mitral regurgitation (MR). The giant LA caused dextro-rotation of the heart, which immediately reverted to normal cardiac position after surgical repair. The case is reported for the unusual manifestation of giant LA as dextroversion.
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Affiliation(s)
- Jay Relan
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Bharath V
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Lamk Kadiyani
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Milind Padmakar Hote
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | | | - Shyam Sunder Kothari
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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44
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Li X, Liu Z, Kong R, Zhang C, Ge S. Robot-assisted beating-heart surgery for atrial septal defect repair in a case of situs inversus totalis with dextrocardia. Int J Med Robot 2021; 17:e2304. [PMID: 34197045 DOI: 10.1002/rcs.2304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 06/01/2021] [Accepted: 06/30/2021] [Indexed: 12/07/2022]
Abstract
BACKGROUND This paper describes a case of a patient with situs inversus totalis (SIT) and dextrocardia in which robotic atrial septal defect (ASD) repair was successfully performed in a beating heart. METHODS AND RESULTS A 45-year-old female patient who had SIT and dextrocardia was diagnosed with secundum ASD 5 years ago. Because of progressive dyspnoea, fatigue, and obvious cough, she came to our hospital for surgical treatment. Transthoracic echocardiography showed the defect located in the middle and lower segments of the atrial septum with a maximum diameter of 27 mm, with a left-to-right shunt. Transcatheter ASD closure could not be performed because there was not enough tissue surrounding the defect. After communicating with the patient, we performed robotic ASD repair in a beating heart using the da Vinci surgical system. The operation was successful, and the patient recovered quickly. CONCLUSION As a minimally invasive approach, robotic cardiac surgery has many advantages and is feasible and safe in suitable patients.
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Affiliation(s)
- Xin Li
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Zhuang Liu
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Ruirui Kong
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Chengxin Zhang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Shenglin Ge
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
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45
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Wang Y, Zhang J, Feng W, Wu Y, Si Z. Prenatal ultrasound combined with cardiovascular casts diagnose symmetrically complex cardiac malformations in two fetuses. Echocardiography 2021; 38:1352-1355. [PMID: 34159654 DOI: 10.1111/echo.15090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/19/2021] [Accepted: 05/02/2021] [Indexed: 11/28/2022] Open
Abstract
Dextrocardia with a ductus arteriosus (DA) malformation is extremely rare. Here, we present a case of dextrocardia complicated with a right DA that is circuitously connecting the pulmonary artery and the right brachiocephalic artery. Coincidentally, the deformities of this fetus are almost symmetrical with those in another fetus (also presented here), which is astonishing and meaningful. Dextrocardia is rare, complicated, and not well understood. In this report, we carefully compared prenatal echocardiographic images and cardiovascular casts from two fetuses. Our report of these cases may provide new insights for cardiologists to better understand dextrocardia and its associated malformations.
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Affiliation(s)
- Yu Wang
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Hubei, China
| | - Jiaqi Zhang
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Hubei, China
| | - Wei Feng
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Hubei, China
| | - You Wu
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Hubei, China
| | - Ziyi Si
- Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Hubei, China
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John K, Mukhdomi T, Kendall MC, Hayward G. Flip Your Perspective: Dextrocardia and its Effect on Monitoring and Management. R I Med J (2013) 2021; 104:38-39. [PMID: 34044436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Kenneth John
- Department of Anesthesiology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI
| | - Taif Mukhdomi
- Department of Anesthesiology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI
| | - Mark C Kendall
- Department of Anesthesiology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI
| | - Geoffrey Hayward
- Department of Anesthesiology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI
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Liu C, Jin T, Meng A, Mao J, Shi R, Liu L. An ECG method for positioning the tip of a PICC in "mirror people" with dextrocardia: A case report. J Vasc Access 2021; 23:962-965. [PMID: 33977821 DOI: 10.1177/11297298211015074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Chunli Liu
- Department of Vascular Access Center, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Tao Jin
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Aifeng Meng
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Mao
- Department of Vascular Access Center, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Ruchun Shi
- Department of Vascular Access Center, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Lagen Liu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
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Ravikumar MS, Palanisamy V, Tamilselvan M, Sangili S, Sethuratnam R. Technical Aspects: Coronary Artery Bypass Grafting in a Case of Dextrocardia With Situs Inversus. Cureus 2021; 13:e14932. [PMID: 34123630 PMCID: PMC8188905 DOI: 10.7759/cureus.14932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Dextrocardia with situs inversus is a rare congenital anomaly in which the heart and the abdominal organs orient themselves in a mirror-image reversal of the normal anatomy. Coronary artery disease incidence is similar to that of the normal population. Performing coronary artery bypass grafting in this subset of the population poses few difficulties. These limitations can be overcome by few technical adjustments by the surgeon and the team which will be discussed in our article.
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Affiliation(s)
| | | | | | - Sureshkumar Sangili
- Department of Cardiothoracic Surgery, Madras Medical Mission Hospital, Chennai, IND
| | - Rajan Sethuratnam
- Department of Cardiothoracic Surgery, Madras Medical Mission Hospital, Chennai, IND
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Abstract
Kartagener syndrome is a rare, autosomal recessive genetic disorder that causes defects in the action of ciliary movement, comprises of triad situs inversus, chronic sinusitis, and bronchiectasis. We present the case of a 3-year-old boy with repeated respiratory infections and pneumonic infections presenting with acute respiratory failure. He was diagnosed with Kartagener syndrome based on his clinical presentation and imaging features. The current diagnosis was consistent with severe acute bronchitis. He was managed initially with conventional medical therapy, but he didn’t respond and was transferred immediately to the pediatric intensive care unit where noninvasive ventilation was administered. He had shown significant predictors of early noninvasive ventilation failure and was mechanically ventilated, after which, he was disconnected from the ventilator and discharged without complications. In patients presenting with recurrent upper and lower respiratory tract infections, Kartagener syndrome should always be kept in mind. The correct diagnosis of this disorder in early life is very important to prevent complications and improve patients’ quality of life.
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Affiliation(s)
- Rahaf Ibrahim
- Pediatric Intensive Care Unit, Children's Damascus University Hospital, Damascus, Syria
| | - Huda Daood
- Pediatric Intensive Care Unit, Children's Damascus University Hospital, Damascus, Syria
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50
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Rahil MA, Hadjmhamed M. Nephronophthisis and central veins abnormalities: A case report. Clin Case Rep 2021; 9:1977-1979. [PMID: 33936626 PMCID: PMC8077304 DOI: 10.1002/ccr3.3920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/02/2020] [Accepted: 01/29/2021] [Indexed: 11/11/2022] Open
Abstract
Patients with genetic disorders are potentially more susceptible to present vascular abnormalities compared to the general population. For these patients, unusual difficulties could appear during a CVC placement procedure that could lead to major complications if venous abnormalities are undiagnosed. Ultrasound and fluoroscopy guidance should be used routinely for all patients in order to avoid complications and catheter misplacement.
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