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全内脏反位患者采用射频能量进行微创二尖瓣置换术及同期Cox迷宫IV手术:一例报告

Minimally invasive mitral valve replacement and concomitant Cox-Maze IV procedure using radiofrequency energy in situs inversus totalis: A case report.

作者信息

Pham Chuong V, Nguyen Dinh H, Vo Anh T, Nguyen Trang T, Phan Ly H, Nguyen Bac H

机构信息

University Medical Center Ho Chi Minh City, Viet Nam.

University Medical Center Ho Chi Minh City, Viet Nam; University of Medicine and Pharmacy At Ho Chi Minh City, Viet Nam.

出版信息

Int J Surg Case Rep. 2020;73:285-288. doi: 10.1016/j.ijscr.2020.07.053. Epub 2020 Jul 18.

Abstract

INTRODUCTION

Situs inversus totalis (SIT) is an uncommon congenital condition characterized by total transposition of abdominal and thoracic viscera. Performing minimally invasive cardiac surgery on individuals with SIT requires different surgical planning because of the unfamiliar positions of the heart and great vessels.

PRESENTATION OF CASE

A 52-year-old female was admitted to our center with palpitations and dyspnea on exertion. Chest X-ray showed dextrocardia. Echocardiography and chest computerized tomography (CT) revealed SIT with severe rheumatic mitral valve disease.

DISCUSSION

Pre-operative three-dimensional (3D) chest CT reconstruction was helpful in surgical planning and management of cardiopulmonary bypass (CPB). Mitral valve replacement and concomitant atrial fibrillation (AF) ablation using radiofrequency (RF) energy via left mini-thoracotomy was successfully performed on the patient.

CONCLUSION

Minimally invasive approach can be safely and effectively employed in patients with SIT.

摘要

引言

全内脏转位(SIT)是一种罕见的先天性疾病,其特征为腹部和胸部脏器完全转位。由于心脏和大血管位置不熟悉,对患有SIT的个体进行微创心脏手术需要不同的手术规划。

病例介绍

一名52岁女性因心悸和劳力性呼吸困难入住我们中心。胸部X线显示右位心。超声心动图和胸部计算机断层扫描(CT)显示全内脏转位合并严重风湿性二尖瓣疾病。

讨论

术前三维(3D)胸部CT重建有助于手术规划和体外循环(CPB)管理。通过左胸小切口成功地为该患者实施了二尖瓣置换术并使用射频(RF)能量进行了同期房颤(AF)消融。

结论

微创方法可安全有效地应用于全内脏转位患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/712a/7388168/9a47221c05eb/gr1.jpg

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