Trans–coronary sinus puncture for catheter ablation and left atrial appendage closure device implantation in a patient with dextrocardia and persistent right superior vena cava

Lador, Adi; Patel, Apoor; Valderrábano, Miguel

doi:10.1016/j.hrcr.2020.08.013

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…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 ].…”

Section: Management Of Cardiac Malposition Patients During Adulthoodmentioning

confidence: 99%

Therapy of Patients with Cardiac Malposition

Rao

2023

Children

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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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Section: Management Of Cardiac Malposition Patients During Adulthoodmentioning

confidence: 99%

Therapy of Patients with Cardiac Malposition

Rao

2023

Children

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“…Dextrocardia with situs solitus can be observed in approximately 7,500–29,000 people worldwide. 1 Dextrocardia is a congenital anomaly in which the heart is abnormally located on the right side of the chest. Situs solitus describes viscera that are in the normal position, with the stomach on the left side.…”

Section: Introductionmentioning

confidence: 99%

Case report of an S-ICD implantation for secondary prevention in a patient with complex congenital heart disease, dextrocardia, and situs solitus

Wiedmann

Simone

Rose

et al. 2022

European Heart Journal - Case Reports

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Background Dextrocardia is a congenital anomaly in which the apex of the heart is abnormally located on the right side of the chest. Situs solitus describes viscera that are in the normal position, with the stomach on the left side. In these patients, implantation of transvenous implantable cardioverter-defibrillator (ICD) can be limited by anatomical abnormalities commonly associated with this condition. Case summary We present the case of a young female patient with absent right atrioventricular (AV) connection, morphologically left systemic ventricle, muscular restrictive ventricular septal defect and dextrocardia with situs solitus who was indicated for secondary prophylactic ICD implantation after resuscitation for polymorphic ventricular tachycardia. Due to a bilateral bidirectional Glenn anastomosis transvenous access via the vena cava superior to the right ventricle could not be achieved. For this reason, we successfully implanted a subcutaneous ICD (S-ICD) with an individually optimized right parasternal electrode position. Potential complications of epimyocardial implantation via re-thoracotomy could thus be circumvented. Discussion In patients with complex congenital heart disease, the S-ICD is an effective method of preventing sudden cardiac death. Our case report demonstrates the feasibility of left S-ICD implantation even in the presence of dextrocardia with situs solitus.

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Successful percutaneous left atrial appendage occlusion for atrial fibrillation in a patient with mirror-image dextrocardia: a case report

Jiang

Zhang

et al. 2022

BMC Cardiovasc Disord

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Background Dextrocardia is a rare congenital condition (1/10,000–12,000) and AF is uncommon (1–2%). Therefore, the occurrence of the two conditions is rare. Percutaneous left atrial appendage occlusion (LAAO) is a treatment to prevent atrial fibrillation (AF)-associated thromboembolic events. Case presentation An 85-year-old female with known situs inversus totalis, persistent AF, and stroke was treated with oral anticoagulation, but she was suffering from constant gingival bleeding. Her CHA2DS2VASc score was 6 points (abnormal, ≥ 2), and her HAS-BLED score was 4 points (abnormal, ≥ 3). The transthoracic echocardiography (TTE) demonstrated left atrial (LA) enlargement (46 mm) and 50% of ejection fraction. She underwent percutaneous LAAO for stroke recurrence prevention using a Watchman occluder. The operation was successful but with technical differences compared with a standard case because of the dextrocardia. Conclusion This is the first reported case of a percutaneous LAAO in situs inversus dextrocardia. This case indicates the feasibility of LAAO in congenital cardiac malposition combined with AF.

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Trans–coronary sinus puncture for catheter ablation and left atrial appendage closure device implantation in a patient with dextrocardia and persistent right superior vena cava

Cited by 3 publications

References 12 publications

Therapy of Patients with Cardiac Malposition

Therapy of Patients with Cardiac Malposition

Case report of an S-ICD implantation for secondary prevention in a patient with complex congenital heart disease, dextrocardia, and situs solitus

Successful percutaneous left atrial appendage occlusion for atrial fibrillation in a patient with mirror-image dextrocardia: a case report

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