Woods Kaitlin E, Awori Hayanga J W, Sloyer Daniel, Henrickson Roy E, Wei Lawrence M, Hayanga Heather K
Department of Medical Education, West Virginia University, Morgantown, WV, USA.
Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA.
Case Rep Anesthesiol. 2020 Dec 14;2020:8885881. doi: 10.1155/2020/8885881. eCollection 2020.
Dextrocardia involves embryologic malformations leading to a right hemithorax heart with rightward apex. Situs inversus encompasses all viscera in mirrored position. A 76-year-old male with dextrocardia with situs inversus presented for coronary artery bypass grafting due to a non-ST elevation myocardial infarction. Management was altered accordingly. Electrocardiography leads and defibrillator pads were reversed. A left internal jugular vein central venous catheter provided direct access to the right atrium. Transesophageal echocardiography confirmation of aortic and venous cannulation required turning the probe right for the right-sided aorta and left for liver visualization, respectively. Proactive surgical and anesthetic management was imperative for the successful and uneventful outcome for this patient.
右位心涉及胚胎发育畸形，导致心脏位于右半胸且心尖向右。内脏反位是指所有内脏呈镜像位置。一名76岁患有右位心并内脏反位的男性因非ST段抬高型心肌梗死接受冠状动脉旁路移植术。相应地调整了管理措施。心电图导联和除颤器电极片位置颠倒。经左颈内静脉置入中心静脉导管可直接进入右心房。经食管超声心动图确认主动脉和静脉插管时，分别需要将探头向右以观察右侧主动脉，向左以观察肝脏。积极的手术和麻醉管理对于该患者成功且顺利康复至关重要。
