Main pulmonary artery aneurysms are rare,mostly asymptomatic and discovered accidentally.The main pulmonary artery aneurysms may be idiopathic or secondary to underlying diseases such as pulmonary hypertension,Behcet...Main pulmonary artery aneurysms are rare,mostly asymptomatic and discovered accidentally.The main pulmonary artery aneurysms may be idiopathic or secondary to underlying diseases such as pulmonary hypertension,Behcet’s disease,connective tissue disorders,congenital heart disease,vasculitis,syphilis,tuberculosis and endocarditis.There are some indices that dextrocardia is associated with anomalies of the pulmonary arteries and pulmonary valve.A rare occurrence of main pulmonary artery aneurysms results in a lack of recommendations,so the remaining challenges are whether main pulmonary artery aneurysms should be treated,how,and when.The decision on surgical intervention or conservative treatment of the main pulmonary artery aneurysms depends on its size,etiology and accompanying diseases and includes a multidisciplinary heart team.Our case of the main pulmonary artery aneurysm and pulmonary valve abnormality associated with Ebstein anomaly and dextrocardia in a 67-year-old male patient brings causality considerations and treatment options in such a unique condition.展开更多
Situs inversus with dextrocardia is a rare congenital anomaly.There are limited published case reports of successful percutaneous coronary intervention(PCI) in these patients who have atherosclerotic coronary artery d...Situs inversus with dextrocardia is a rare congenital anomaly.There are limited published case reports of successful percutaneous coronary intervention(PCI) in these patients who have atherosclerotic coronary artery disease,especially when presenting with acute myocardial infarction.PCI is technically difficult be-cause of mirror image dextrocardia.We hereby de-scribe a 48-yr-old female,who had acute inferior wall myocardial infarction and underwent successful emer-gency primary coronary angioplasty and stenting of a proximally occluded right coronary artery.Technical details about PCI are discussed.展开更多
BACKGROUND In mirror-image dextrocardia,the anterior-posterior position of the cardiac chambers and great vessels is maintained,but the left-right orientation of the abdominal organs is reversed.The abnormal anatomy o...BACKGROUND In mirror-image dextrocardia,the anterior-posterior position of the cardiac chambers and great vessels is maintained,but the left-right orientation of the abdominal organs is reversed.The abnormal anatomy of the heart poses surgical challenges and problems in dealing with surgical risk and monitoring complications.There are few reports on closure of the left atrial appendage(LAA)in dextrocardia and no reports on the application of enhanced recovery after surgery(ERAS)following LAA occlusion(LAAO)procedures.CASE SUMMARY The objective for this case was to ensure perioperative safety and accelerate postoperative recovery from LAAO in a patient with mirror-image dextrocardia.ERAS was guided by the theory and practice of nursing care.Atrial fibrillation was diagnosed in a 77-year-old male patient,in whom LAAO was performed.The 2019 guidelines for perioperative care after cardiac surgery recommend that the clinical nursing procedures for patients with LAAO should be optimized to reduce the incidence of perioperative complications and ensure patient safety.Music therapy can be used throughout perioperative treatment and nursing to improve the anxiety symptoms of patients.CONCLUSION The procedure was uneventful and proceeded without complications.Anxiety symptoms were improved.展开更多
BACKGROUND Hemifacial microsomia(HFM)is a rare congenital malformation characterized by a combination of various anomalies,including the face,ears,eyes,and vertebrae.Prenatal diagnosis for HFM is possible,and quite ac...BACKGROUND Hemifacial microsomia(HFM)is a rare congenital malformation characterized by a combination of various anomalies,including the face,ears,eyes,and vertebrae.Prenatal diagnosis for HFM is possible,and quite accurate ultrasound can detect obvious defects.The etiology is still unknown,although some hypotheses have been proposed,including gene mutation,chromosome anomaly,and environmental risk factors.However,there are few reports of pulmonary hypoplasia and dextrocardia in HFM.CASE SUMMARY A 2-year-old boy presented to the ear reconstruction department of our hospital complaining of deviation of the face to the right side and auricular anomaly.Physical examination revealed facial asymmetry,preauricular skin tags,and concha-type microtia with stricture of the external auditory canal on the right side.Head magnetic resonance imaging showed bilateral semicircular canal dysplasia and bilateral internal auditory canals stenosis.Audiometric examination showed bilateral severe sensorineural hearing loss.Chest radiography and computed tomography showed dextrocardia and right pulmonary hypoplasia.CONCLUSION This case presented a rare finding and an unusual association of 3 malformations,ipsilateral HFM,pulmonary agenesis,and dextrocardia.展开更多
Dextrocardia refers to a right-sided location of the heart within the thoracic cavity which is the primary manifestation of the abnormal lateralisation of the embryonic leftright axis.[1]As a rare cardiac malformation...Dextrocardia refers to a right-sided location of the heart within the thoracic cavity which is the primary manifestation of the abnormal lateralisation of the embryonic leftright axis.[1]As a rare cardiac malformation,the prevalence rate of dextrocardia is between 1/6000 to 1/35000 live births.[2]It is reported that the incidence rate of coronary artery disease for dextrocardia patients is similar for patients without dextrocardia.However,the detailed information including electrocardiogram(ECG)manifestation and percutaneous coronary intervention(PCI)technique for dextrocardia patients is still limited.[3,4]Herein,we report a dextrocardia patient who was diagnosed by modified ECG and treated by trans-radial PCI facilitated with guiding extension catheter(GEC).展开更多
A 26-year-old patient with mirror-image dextrocardia and situs inversus experienced a transient ischemic attack.We suspected that a patent foramen ovale was the reason.A Cardi-O-Fix occluder was used to close the pate...A 26-year-old patient with mirror-image dextrocardia and situs inversus experienced a transient ischemic attack.We suspected that a patent foramen ovale was the reason.A Cardi-O-Fix occluder was used to close the patent foramen ovale with a mirror-reversed rotation of the radiologic views.During the 18-month follow-up,no symptoms of the transient ischemic attack appeared again.展开更多
Background Isolated dextrocardia is a rare phenomenon a nd usually associated with multiple cardiac anomalies. This study was to evaluat e the accuracy of diagnosis of isolated dextrocardia by using angiocardiography...Background Isolated dextrocardia is a rare phenomenon a nd usually associated with multiple cardiac anomalies. This study was to evaluat e the accuracy of diagnosis of isolated dextrocardia by using angiocardiography and to compare it with the results of surgery.Methods The clinical data of 27 cases of congenital isolated dextrocardia were collected to understand the diagnostic approaches to the major cardiac anomalies. All cases underwent angiocardiography followed by palliative or curative surgery. The diagnosis was compared by angiocardiography relying on segmental analysis with the pathological features observed in surgery.Results The results of angiocardiography of 22 patients were the same as the pathological features observed during surgery, including one case with congenital left ventricular diverticulum was inadvertently omitted in angiocardiograhy. There were significantly dissimilar diagnoses between angiocardiograhy and post-operation in 5 patients, including anatomical corrected transposition of great arteries misinterpreted as corrected transposition of the great arteries in 1, complete transposition of great arteries misinterpreted as corrected transposition of the great arteries in 1, single ventricle misinterpreted as double-outlet right ventricle in 1, and anatomical double-outlet left ventricle misinterpreted as corrected transposition of the great arteries in 2. Misdiagnostic rate of angiocardiograhy was almost 20%.Conclusions Angiocardiography is of great significance in the diagnosis and classification of isolated dextrocardia. However, because of the intricacy of cardiac anomalies of isolated dextrocardia, atrial angiography and double oblique projection are needed to improve the accuracy of diagnosis to support surgical treatments.展开更多
Transcatheter occlusion of patent ductus arterious （PDA） using various occluders and coils has been a well-established method since Porstmann and colleagues reported the first case in 1967. However, when patients as...Transcatheter occlusion of patent ductus arterious （PDA） using various occluders and coils has been a well-established method since Porstmann and colleagues reported the first case in 1967. However, when patients associated with anomalous inferior vein cava drainage or/and huge high pulmonary artery pressure ductus （HPAP-PDA）, the method is not suitable. First, it is unfeasible to carry out the procedure via femoral vein. Second,展开更多
Dextrocardia is a rare anomaly where the heart is located on the right side of the chest instead of the normal left side. Ablation of atrial fibrillation （AF） with such an inverted anatomy may be challenging for the...Dextrocardia is a rare anomaly where the heart is located on the right side of the chest instead of the normal left side. Ablation of atrial fibrillation （AF） with such an inverted anatomy may be challenging for the manipulation of the catheters. Here we report a case of dextrocardia who underwent ablation for persistent AF guided by image integration system.展开更多
Although situs inversus with dextrocardia is a rare clinical phenomenon, the association with coronary artery disease（CAD） is at the same frequency as in the general popuLation. Few cases of dextrocardia complicated...Although situs inversus with dextrocardia is a rare clinical phenomenon, the association with coronary artery disease（CAD） is at the same frequency as in the general popuLation. Few cases of dextrocardia complicated with CAD was reported before. The feasibility and prognosis of percutaneous coronary intervention （PCI） in such case still remains unclear because of the uncommon anatomical abnormality, especially in the drug-eluting stent （DES） era. Here we report a female case with dextrocardia and CAD was successfully treated by DES implantation.展开更多
BACKGROUND Situs inversus totalis(SIT)may be an incidental finding in asymptomatic children.Patients may not understand the implications of this condition and the importance of relaying the diagnosis to their healthca...BACKGROUND Situs inversus totalis(SIT)may be an incidental finding in asymptomatic children.Patients may not understand the implications of this condition and the importance of relaying the diagnosis to their healthcare providers.CASE SUMMARY We report an asymptomatic seventeen-year-old adolescent with previouslydiagnosed SIT who presented for a routine well-child visit.During history taking,he denied any past medical conditions,including cardiovascular conditions.Only when physical exam revealed point of maximal impulse and heart sounds on the right side,did he convey that he had been diagnosed with SIT incidentally at age of 12 years.He was not aware of associated conditions or the potential implications of his diagnosis,nor did he realize it is pertinent medical history to be relayed to healthcare providers.Chest X-ray confirmed dextrocardia and abdominal X-ray showed right-sided stomach.Abdomen sonogram showed left-sided liver and right-sided spleen.Echocardiogram showed normal valvular structure and function.A comprehensive discussion was provided to address the patient’s lack of understanding that SIT is a medical diagnosis with potential implications.CONCLUSION While SIT is rare and mostly asymptomatic,affected patients may not comprehend the importance of the diagnosis and its potential ramifications.Recognition of the patient’s lack of awareness allows the healthcare provider to educate the patient and hopefully can prevent potential medical and surgical complications.展开更多
文摘Main pulmonary artery aneurysms are rare,mostly asymptomatic and discovered accidentally.The main pulmonary artery aneurysms may be idiopathic or secondary to underlying diseases such as pulmonary hypertension,Behcet’s disease,connective tissue disorders,congenital heart disease,vasculitis,syphilis,tuberculosis and endocarditis.There are some indices that dextrocardia is associated with anomalies of the pulmonary arteries and pulmonary valve.A rare occurrence of main pulmonary artery aneurysms results in a lack of recommendations,so the remaining challenges are whether main pulmonary artery aneurysms should be treated,how,and when.The decision on surgical intervention or conservative treatment of the main pulmonary artery aneurysms depends on its size,etiology and accompanying diseases and includes a multidisciplinary heart team.Our case of the main pulmonary artery aneurysm and pulmonary valve abnormality associated with Ebstein anomaly and dextrocardia in a 67-year-old male patient brings causality considerations and treatment options in such a unique condition.
文摘Situs inversus with dextrocardia is a rare congenital anomaly.There are limited published case reports of successful percutaneous coronary intervention(PCI) in these patients who have atherosclerotic coronary artery disease,especially when presenting with acute myocardial infarction.PCI is technically difficult be-cause of mirror image dextrocardia.We hereby de-scribe a 48-yr-old female,who had acute inferior wall myocardial infarction and underwent successful emer-gency primary coronary angioplasty and stenting of a proximally occluded right coronary artery.Technical details about PCI are discussed.
基金Supported by Pudong New Area Science and Technology Development Fund Livelihood Scientific Research Project:Medical and Health,No.PKJ2020-Y106Shanghai Pudong New District Medical Discipline Construction Project C Cardiovascular Internal Medicine Clinical Plateau Discipline,No.PWYgy2018-03+1 种基金Shanghai Key Medical Specialty Construction Project,No.ZK2019B25Scientific Research Project of Shanghai Municipal Health and Family Planning Commission(Youth Project),No.20184Y0230.
文摘BACKGROUND In mirror-image dextrocardia,the anterior-posterior position of the cardiac chambers and great vessels is maintained,but the left-right orientation of the abdominal organs is reversed.The abnormal anatomy of the heart poses surgical challenges and problems in dealing with surgical risk and monitoring complications.There are few reports on closure of the left atrial appendage(LAA)in dextrocardia and no reports on the application of enhanced recovery after surgery(ERAS)following LAA occlusion(LAAO)procedures.CASE SUMMARY The objective for this case was to ensure perioperative safety and accelerate postoperative recovery from LAAO in a patient with mirror-image dextrocardia.ERAS was guided by the theory and practice of nursing care.Atrial fibrillation was diagnosed in a 77-year-old male patient,in whom LAAO was performed.The 2019 guidelines for perioperative care after cardiac surgery recommend that the clinical nursing procedures for patients with LAAO should be optimized to reduce the incidence of perioperative complications and ensure patient safety.Music therapy can be used throughout perioperative treatment and nursing to improve the anxiety symptoms of patients.CONCLUSION The procedure was uneventful and proceeded without complications.Anxiety symptoms were improved.
基金Supported by the National Natural Science Foundation of China,No. 81701930
文摘BACKGROUND Hemifacial microsomia(HFM)is a rare congenital malformation characterized by a combination of various anomalies,including the face,ears,eyes,and vertebrae.Prenatal diagnosis for HFM is possible,and quite accurate ultrasound can detect obvious defects.The etiology is still unknown,although some hypotheses have been proposed,including gene mutation,chromosome anomaly,and environmental risk factors.However,there are few reports of pulmonary hypoplasia and dextrocardia in HFM.CASE SUMMARY A 2-year-old boy presented to the ear reconstruction department of our hospital complaining of deviation of the face to the right side and auricular anomaly.Physical examination revealed facial asymmetry,preauricular skin tags,and concha-type microtia with stricture of the external auditory canal on the right side.Head magnetic resonance imaging showed bilateral semicircular canal dysplasia and bilateral internal auditory canals stenosis.Audiometric examination showed bilateral severe sensorineural hearing loss.Chest radiography and computed tomography showed dextrocardia and right pulmonary hypoplasia.CONCLUSION This case presented a rare finding and an unusual association of 3 malformations,ipsilateral HFM,pulmonary agenesis,and dextrocardia.
基金the Chinese Cardiovascular Association-V.G.(2017-CCA-VG-042).
文摘Dextrocardia refers to a right-sided location of the heart within the thoracic cavity which is the primary manifestation of the abnormal lateralisation of the embryonic leftright axis.[1]As a rare cardiac malformation,the prevalence rate of dextrocardia is between 1/6000 to 1/35000 live births.[2]It is reported that the incidence rate of coronary artery disease for dextrocardia patients is similar for patients without dextrocardia.However,the detailed information including electrocardiogram(ECG)manifestation and percutaneous coronary intervention(PCI)technique for dextrocardia patients is still limited.[3,4]Herein,we report a dextrocardia patient who was diagnosed by modified ECG and treated by trans-radial PCI facilitated with guiding extension catheter(GEC).
文摘A 26-year-old patient with mirror-image dextrocardia and situs inversus experienced a transient ischemic attack.We suspected that a patent foramen ovale was the reason.A Cardi-O-Fix occluder was used to close the patent foramen ovale with a mirror-reversed rotation of the radiologic views.During the 18-month follow-up,no symptoms of the transient ischemic attack appeared again.
文摘Background Isolated dextrocardia is a rare phenomenon a nd usually associated with multiple cardiac anomalies. This study was to evaluat e the accuracy of diagnosis of isolated dextrocardia by using angiocardiography and to compare it with the results of surgery.Methods The clinical data of 27 cases of congenital isolated dextrocardia were collected to understand the diagnostic approaches to the major cardiac anomalies. All cases underwent angiocardiography followed by palliative or curative surgery. The diagnosis was compared by angiocardiography relying on segmental analysis with the pathological features observed in surgery.Results The results of angiocardiography of 22 patients were the same as the pathological features observed during surgery, including one case with congenital left ventricular diverticulum was inadvertently omitted in angiocardiograhy. There were significantly dissimilar diagnoses between angiocardiograhy and post-operation in 5 patients, including anatomical corrected transposition of great arteries misinterpreted as corrected transposition of the great arteries in 1, complete transposition of great arteries misinterpreted as corrected transposition of the great arteries in 1, single ventricle misinterpreted as double-outlet right ventricle in 1, and anatomical double-outlet left ventricle misinterpreted as corrected transposition of the great arteries in 2. Misdiagnostic rate of angiocardiograhy was almost 20%.Conclusions Angiocardiography is of great significance in the diagnosis and classification of isolated dextrocardia. However, because of the intricacy of cardiac anomalies of isolated dextrocardia, atrial angiography and double oblique projection are needed to improve the accuracy of diagnosis to support surgical treatments.
文摘Transcatheter occlusion of patent ductus arterious （PDA） using various occluders and coils has been a well-established method since Porstmann and colleagues reported the first case in 1967. However, when patients associated with anomalous inferior vein cava drainage or/and huge high pulmonary artery pressure ductus （HPAP-PDA）, the method is not suitable. First, it is unfeasible to carry out the procedure via femoral vein. Second,
文摘Dextrocardia is a rare anomaly where the heart is located on the right side of the chest instead of the normal left side. Ablation of atrial fibrillation （AF） with such an inverted anatomy may be challenging for the manipulation of the catheters. Here we report a case of dextrocardia who underwent ablation for persistent AF guided by image integration system.
文摘Although situs inversus with dextrocardia is a rare clinical phenomenon, the association with coronary artery disease（CAD） is at the same frequency as in the general popuLation. Few cases of dextrocardia complicated with CAD was reported before. The feasibility and prognosis of percutaneous coronary intervention （PCI） in such case still remains unclear because of the uncommon anatomical abnormality, especially in the drug-eluting stent （DES） era. Here we report a female case with dextrocardia and CAD was successfully treated by DES implantation.
文摘BACKGROUND Situs inversus totalis(SIT)may be an incidental finding in asymptomatic children.Patients may not understand the implications of this condition and the importance of relaying the diagnosis to their healthcare providers.CASE SUMMARY We report an asymptomatic seventeen-year-old adolescent with previouslydiagnosed SIT who presented for a routine well-child visit.During history taking,he denied any past medical conditions,including cardiovascular conditions.Only when physical exam revealed point of maximal impulse and heart sounds on the right side,did he convey that he had been diagnosed with SIT incidentally at age of 12 years.He was not aware of associated conditions or the potential implications of his diagnosis,nor did he realize it is pertinent medical history to be relayed to healthcare providers.Chest X-ray confirmed dextrocardia and abdominal X-ray showed right-sided stomach.Abdomen sonogram showed left-sided liver and right-sided spleen.Echocardiogram showed normal valvular structure and function.A comprehensive discussion was provided to address the patient’s lack of understanding that SIT is a medical diagnosis with potential implications.CONCLUSION While SIT is rare and mostly asymptomatic,affected patients may not comprehend the importance of the diagnosis and its potential ramifications.Recognition of the patient’s lack of awareness allows the healthcare provider to educate the patient and hopefully can prevent potential medical and surgical complications.
