Left atrial appendage occlusion in a mirror-image dextrocardia: A case report and review of literature

Abstract

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.

Therapy of Patients with Cardiac Malposition

“…Subjects who have atrial fibrillation/flutter are at risk of developing embolic episodes and, therefore, initial anticoagulation and subsequent occlusion of the left atrial appendage are recommended. While closure of the appendage of the left atrium is challenging in dextrocardia subjects, it can be successfully accomplished [ 118 , 119 , 120 ].…”