Namboodiri Narayanan, Harikrishnan Sivadasan Pillai, Ajitkumar Valaparambil, Tharakan Jaganmohan Achuthan
Cardiology Department, SCTIMST, Trivandrum, India.
J Invasive Cardiol. 2008 Jan;20(1):E33-5.
A 43-year-old male with mirror-image dextrocardia and severe rheumatic mitral stenosis was subjected to successful percutaneous transvenous mitral commissurotomy (PTMC). The standard Inoue technique was modified by transseptal catheterization via the left femoral vein, image inversion, delineation of the interatrial septal anatomy via levophase pulmonary angiography, septal contrast staining and pigtail catheter insertion in the noncoronary aortic sinus, interatrial septal puncture with the transseptal needle rotated to a 7 o'clock position and left ventricular entry with a reverse loop technique. There were no procedural complications. Intracardiac pressures and mitral valvular planimetry suggested a successful procedural outcome. This case illustrates that PTMC can be accomplished safely in patients with this unusual cardiac anatomy with a few modifications in the standard technique.
一名43岁男性，患有镜像右位心和严重风湿性二尖瓣狭窄，接受了成功的经皮经静脉二尖瓣交界切开术（PTMC）。通过经左股静脉进行房间隔穿刺插管、图像反转、通过左心相肺血管造影描绘房间隔解剖结构、房间隔造影染色以及在无冠状动脉主动脉窦插入猪尾导管、将房间隔穿刺针旋转至7点位置并采用反向环技术进入左心室，对标准的井上技术进行了改良。术中无并发症。心内压力和二尖瓣平面测量提示手术结果成功。该病例表明，对标准技术进行一些改良后，PTMC可在具有这种特殊心脏解剖结构的患者中安全完成。
