Nivargi Varun, Makhale Chandrashekhar, Kulkarni Vihita
Cardiology Fellow, Ruby Hall Clinic, Pune, Maharashtra.
Cardiology HOD, Ruby Hall Clinic, Pune, Maharashtra.
J Assoc Physicians India. 2019 Apr;67(4):94-95.
32 years old male with history of mirror image dextrocardia with situs inversus and history of rheumatic fever at age of 12 years on penicillin prophylaxis till 25 years of age presented with history of dyspnea on exertion NYHA class 2 since last five years. Cardiac colour Doppler 5 years back was suggestive of rheumatic mitral stenosis with mitral valve area 2 cm2 with mirror image dextrocardia with mild pulmonary arteriolar hypertension in normal sinus rhythm. Patient was put on medications and was advised regular follow up. Patient did not follow up regularly. Cardiac colour doppler 5 years later showed mitral valve area of 0.8 cm2 with suprasystemic pulmonary arterial hypertension of 130 mmhg . Hence was advised percutaneous balloon mitral valvuloplasty. Balloon mitral valvuloplasty was done successfully without inverting the images on fluoroscopy using left femoral approach. Post balloon mitral valvuloplasty mitral valve area increased significantly with mild mitral regurgitation and regression of pulmonary arterial pressures to half the original values.
一名32岁男性，有镜像右位心伴内脏反位病史，12岁时有风湿热病史，青霉素预防治疗至25岁，自过去五年以来有劳力性呼吸困难史，纽约心脏协会（NYHA）心功能分级为2级。5年前心脏彩色多普勒检查提示风湿性二尖瓣狭窄，二尖瓣面积为2平方厘米，伴有镜像右位心及正常窦性心律下的轻度肺小动脉高压。患者接受了药物治疗并被建议定期随访。但患者未定期随访。5年后心脏彩色多普勒检查显示二尖瓣面积为0.8平方厘米，伴有130毫米汞柱的系统性高血压。因此建议行经皮球囊二尖瓣成形术。使用左股动脉入路，在荧光透视下未翻转图像成功完成了球囊二尖瓣成形术。球囊二尖瓣成形术后二尖瓣面积显著增加，伴有轻度二尖瓣反流，肺动脉压降至原值的一半。
