Related Experiment Videos
[Emergent coronary artery bypass grafting in a patient with mirror-image dextrocardia]
Insights
This case report details the first coronary artery bypass grafting in a patient with mirror-image dextrocardia and severe left main trunk stenosis. The successful surgery highlights the feasibility of complex cardiac procedures in rare anatomical variations.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Disease
- Medical Case Reports
Background:
- Situs inversus totalis is a rare congenital condition where major visceral organs are mirrored.
- Left main trunk stenosis is a critical condition requiring prompt intervention.
- Coronary artery bypass grafting (CABG) is a standard treatment for severe coronary artery disease.
Observation:
- A 49-year-old male with situs inversus totalis presented with angina pectoris.
- Coronary arteriography revealed 90% stenosis of the left main trunk.
- The patient experienced hemodynamic deterioration post-arteriography, necessitating intra-aortic balloon pump support.
Findings:
- Emergent coronary artery bypass grafting using saphenous veins was successfully performed.
- The patient recovered uneventfully from the complex surgical procedure.
- This represents the first reported instance of CABG in a patient with mirror-image dextrocardia and left main trunk stenosis.
Implications:
- This case demonstrates the successful surgical management of critical coronary artery disease in a patient with situs inversus totalis.
- It highlights the adaptability of surgical techniques to rare anatomical variations.
- Further research into managing complex cardiac conditions in patients with situs inversus is warranted.
Abstract:
A 49 year-old-man with known situs inversus totalis was admitted to our hospital with a history of angina pectoris of 4 months duration. Coronary arteriography revealed that the left main trunk had a 90% stenosis. After the arteriography, the patient's hemodynamics was deteriorated, and he required a support of intraaortic balloon pumping. He underwent emergent coronary artery bypass grafting with saphenous veins the following day, and recovered uneventfully. Technical problems in this patient from a surgical viewpoint were discussed. As far as we know, this is the first case of coronary bypass grafting on a patient with mirror-image dextrocardia and a stenosis of the left main trunk.