Zhang Zengfu, Fu Xiaohong, Guo Min, Gao Jia, Wang Rui
The First Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi, China.
Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Front Cardiovasc Med. 2025 Jan 15;11:1525387. doi: 10.3389/fcvm.2024.1525387. eCollection 2024.
Dextrocardia is a rare congenital condition, affecting approximately 1 in 10,000-12,000 individuals. When combined with atrial fibrillation (AF), it becomes even rarer. "One-stop" surgery, including combined radiofrequency ablation (RFA) and left atrial appendage occlusion (LAAO), has become a common clinical treatment for patients with AF who develop cerebral infarction despite regular oral anticoagulants. To date, no cases have been reported of patients with AF and dextrocardia undergoing the "one-stop" procedure, making this surgery particularly challenging.
An 85-year-old dextrocardia male with total visceral inversion and persistent AF developed cerebral infarction despite regular oral anticoagulation therapy. He was referred to our hospital for RFA of AF and LAAO. The procedure was successfully performed using a three-dimensional electroanatomical mapping system (Carto3, Biosense Webster, Diamond Bar, CA, USA), intracardiac echocardiography (ICE), and x-ray, with no complications.
This is the first reported case of a "one-stop" surgery for dextrocardia with AF. This procedure is safe and feasible with the assistance of advanced technologies such as ICE and the VIZIGO bidirectional adjustable bent sheath.
右位心是一种罕见的先天性疾病，发病率约为万分之一至万分之一点二。当合并心房颤动（房颤）时，情况更为罕见。“一站式”手术，包括联合射频消融（RFA）和左心耳封堵（LAAO），已成为房颤患者在规律口服抗凝药情况下仍发生脑梗死时的常见临床治疗方法。迄今为止，尚无房颤合并右位心患者接受“一站式”手术的病例报道，这使得该手术极具挑战性。
一名85岁的右位心男性，伴有完全性内脏转位和持续性房颤，尽管接受了规律的口服抗凝治疗仍发生了脑梗死。他因房颤射频消融和左心耳封堵被转诊至我院。手术在三维电解剖标测系统（Carto3，美国加利福尼亚州钻石吧市Biosense Webster公司）、心腔内超声心动图（ICE）和X线辅助下成功完成，无并发症发生。
这是首例报道右位心合并房颤的“一站式”手术病例。在ICE和VIZIGO双向可调弯鞘等先进技术的辅助下，该手术安全可行。
