دورية أكاديمية
Percutaneous coronary intervention for chronic total occlusion of the left circumflex branch in mirror dextrocardia: a case report.
| العنوان: | Percutaneous coronary intervention for chronic total occlusion of the left circumflex branch in mirror dextrocardia: a case report. |
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| المؤلفون: | Hailin D; Cardiovascular Department, Chengdu Qingbaijiang District People's Hospital, No.15, Fenghuang East 4th Road, Qingbaijiang District, Chengdu, 610399, Sichuan, China., Hongtu Q; Cardiovascular Department, Chengdu Qingbaijiang District People's Hospital, No.15, Fenghuang East 4th Road, Qingbaijiang District, Chengdu, 610399, Sichuan, China., Wenyong Z; Cardiovascular Department, Chengdu Qingbaijiang District People's Hospital, No.15, Fenghuang East 4th Road, Qingbaijiang District, Chengdu, 610399, Sichuan, China. zwyde@163.com. |
| المصدر: | Journal of medical case reports [J Med Case Rep] 2023 Nov 22; Vol. 17 (1), pp. 486. Date of Electronic Publication: 2023 Nov 22. |
| نوع المنشور: | Case Reports; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101293382 Publication Model: Electronic Cited Medium: Internet ISSN: 1752-1947 (Electronic) Linking ISSN: 17521947 NLM ISO Abbreviation: J Med Case Rep Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [London] : BioMed Central, [2007- |
| مواضيع طبية MeSH: | Atrial Fibrillation* , Coronary Occlusion*/diagnostic imaging , Coronary Occlusion*/surgery , Dextrocardia*/complications , Dextrocardia*/diagnostic imaging , Dextrocardia*/surgery , Percutaneous Coronary Intervention*/methods, Humans ; Male ; Chest Pain/etiology ; Chronic Disease ; Coronary Angiography ; Dyspnea ; Treatment Outcome ; Middle Aged |
| مستخلص: | Background: Mirror dextrocardia (MDC) is a condition in which the heart is located in a mirror-image position on the right side of the chest compared to the normal position in individuals with physiological variations. Patients with MDC and chronic total occlusion (CTO) of the left circumflex branch (LCX) are extremely rare in clinical practice. The treatment of MDC-CTO-LCX differs significantly from patients without mirror dextrocardia and the same condition in terms of instrument selection and procedural techniques. In this article, we report a successful case of interventional treatment in a patient with MDC-CTO-LCX. We summarize the anatomical and electrocardiographic variations in patients with MDC-CTO-LCX, and discuss the selection of interventional instruments and techniques that can be useful for interventionists as well as the diagnostic and therapeutic considerations that can be helpful for clinical physicians. Case Presentation: A male Han Chinese patient, 51, was admitted, presenting recurrent chest pain for a year and recent onset of exertional fatigue over the past week.He reported episodes of chest pain following physical activities over the past year, lasting between 5 and 20 min.Despite these symptoms, the patient did not seek immediate medical attention, and the occurrence of his chest pain has progressively lessened within the year.A week prior, the patient developed exertional dyspnea after brief walks, though without any episodes of nocturnal paroxysmal dyspnea.Upon arrival at our hospital for evaluation, he was initially diagnosed with chronic coronary syndrome, previous inferior myocardial infarction, atrial arrhythmia, and classified under the New York Heart Association functional class III.Following his admission, a chest X-ray and coronary angiography were conducted.The results indicated mirror dextrocardia and total occlusion of the left circumflex branch. Percutaneous coronary intervention (PCI) was performed on the left circumflex branch. Subsequent angiography demonstrated optimal stent positioning without evidence of hematoma or dissection.Following the procedure, the patient's symptoms of chest pain and exertional dyspnea were resolved, which led to his subsequent discharge.A follow-up electrocardiogram, 10 months post-procedure, displayed a slow and regular atrial rhythm. Conclusions: The incidence of dextrocardia is very low, and it may appear normal on an electrocardiogram; however, careful diagnosis is required when there is an abnormal direction of the P wave in limb leads. During the operation for chronic occlusive lesions of the right-sided coronary artery, the anomalous anatomical structure necessitates specific requirements for instrument selection and operative techniques. After revascularization of chronic occlusive vessels in dextrocardia, routine electrocardiographic examination may show false normalization, requiring caution in interpretation. (© 2023. The Author(s).) |
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| معلومات مُعتمدة: | Q21079 Sichuan Medical Association |
| فهرسة مساهمة: | Keywords: Chronic total occlusion; Mirror dextrocardia; Percutaneous coronary intervention |
| تواريخ الأحداث: | Date Created: 20231122 Date Completed: 20231129 Latest Revision: 20231129 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC10664485 |
| DOI: | 10.1186/s13256-023-04196-2 |
| PMID: | 37990278 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1752-1947 |
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| DOI: | 10.1186/s13256-023-04196-2 |