Chakravarthy Murali, Jawali Vivek, Nijagal Devananda
Wockhardt HeartIinstitute, Bangalore, Karnataka, India.
Ann Thorac Cardiovasc Surg. 2008 Jun;14(3):187-91.
Dextrocardia is a rare condition that may be congenital (situs inversus) or acquired (pseudodextrocardia). Since individuals with this ailment have normal cardiac physiology and function, they may live normal lives. Similar to the general population, however, they might be susceptible to ischemic heart disease and present to a cardiothoracic surgical department for coronary artery bypass surgery. We report two cases: one of dextrocardia (situs inversus) and another resulting from an elevation of the left hemidiaphragm, causing pseudodextrocardia. To operate on patients with dextrocardia, surgeons may need to make a few modifications. These include using the right internal mammary artery as a conduit for the "left" anterior descending artery, lengthening the left internal mammary artery to reach the left anterior descending artery, and sometimes the operating surgeon may need to stand at the left side of the operating table. The careful planning of work on the conduits in the preoperative period requires prudence. This report highlights the surgical difficulties during operations on patients with situs inversus or pseudodextrocardia.
右位心是一种罕见的病症，可能是先天性的（内脏反位）或后天获得性的（假性右位心）。由于患有这种疾病的个体心脏生理和功能正常，他们可能过着正常的生活。然而，与普通人群一样，他们可能易患缺血性心脏病，并前往心胸外科进行冠状动脉搭桥手术。我们报告两例病例：一例是右位心（内脏反位），另一例是由于左半膈抬高导致的假性右位心。对于右位心患者进行手术时，外科医生可能需要做一些调整。这些调整包括使用右乳内动脉作为“左”前降支动脉的血管桥、延长左乳内动脉以到达左前降支动脉，有时手术医生可能需要站在手术台左侧。术前对血管桥操作进行仔细规划需要谨慎。本报告强调了内脏反位或假性右位心患者手术过程中的手术难点。
