Tian Bei, Ma Chuang, Su Jin-Wen, Luo Jun, Sun Hong-Xia, Su Jie, Ning Zhong-Ping
Zhoupu Hospital Shanghai University of Medicine & Health Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
World J Clin Cases. 2022 Feb 6;10(4):1357-1365. doi: 10.12998/wjcc.v10.i4.1357.
In mirror-image dextrocardia, the anterior-posterior position of the cardiac chambers and great vessels is maintained, but the left-right orientation of the abdominal organs is reversed. The abnormal anatomy of the heart poses surgical challenges and problems in dealing with surgical risk and monitoring complications. There are few reports on closure of the left atrial appendage (LAA) in dextrocardia and no reports on the application of enhanced recovery after surgery (ERAS) following LAA occlusion (LAAO) procedures.
The objective for this case was to ensure perioperative safety and accelerate postoperative recovery from LAAO in a patient with mirror-image dextrocardia. ERAS was guided by the theory and practice of nursing care. Atrial fibrillation was diagnosed in a 77-year-old male patient, in whom LAAO was performed. The 2019 guidelines for perioperative care after cardiac surgery recommend that the clinical nursing procedures for patients with LAAO should be optimized to reduce the incidence of perioperative complications and ensure patient safety. Music therapy can be used throughout perioperative treatment and nursing to improve the anxiety symptoms of patients.
The procedure was uneventful and proceeded without complications. Anxiety symptoms were improved.
在镜像右位心患者中，心腔和大血管的前后位置保持不变，但腹部器官的左右方向相反。心脏的异常解剖结构给手术带来了挑战，以及在处理手术风险和监测并发症方面存在问题。关于右位心患者左心耳（LAA）闭合的报道很少，且没有关于左心耳封堵术（LAAO）后应用加速康复外科（ERAS）的报道。
本病例的目的是确保一名镜像右位心患者LAAO围手术期的安全并加速术后康复。ERAS以护理理论和实践为指导。一名77岁男性患者被诊断为心房颤动，并接受了LAAO手术。2019年心脏手术后围手术期护理指南建议，应优化LAAO患者的临床护理程序，以降低围手术期并发症的发生率并确保患者安全。音乐疗法可用于整个围手术期的治疗和护理，以改善患者的焦虑症状。
手术过程顺利，未出现并发症。焦虑症状得到改善。
