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To evaluate the genetic etiology of fetal dextrocardia, associated ultrasound anomalies, and perinatal outcomes, we investigated the utility of whole exome sequencing (WES) for prenatal diagnosis of dextrocardia. Fetuses with dextrocardia were prospectively collected between January 2016 and December 2022. Trio-WES was performed on fetuses with dextrocardia, following normal karyotyping and/or chromosomal microarray analysis (CMA) results. A total of 29 fetuses with dextrocardia were collected, including 27 (93.1%) diagnosed with situs inversus totalis and 2 (6.9%) with situs inversus partialis. Cardiac malformations were present in nine cases, extra-cardiac anomalies were found in seven cases, and both cardiac and extra-cardiac malformations were identified in one case. The fetal karyotypes and CMA results of 29 cases were normal. Of the 29 cases with dextrocardia, 15 underwent WES, and the other 14 cases refused. Of the 15 cases that underwent WES, clinically relevant variants were identified in 5/15 (33.3%) cases, including the diagnostic variants DNAH5 , DNAH11 , LRRC56 , PEX10 , and ZIC3 , which were verified by Sanger sequencing. Of the 10 cases with non-diagnostic results via WES, eight (80%) chose to continue the pregnancies. Of the 29 fetuses with dextrocardia, 10 were terminated during pregnancy, and 19 were live born. Fetal dextrocardia is often accompanied by cardiac and extra-cardiac anomalies, and fetal dextrocardia accompanied by situs inversus is associated with a high risk of primary ciliary dyskinesia. Trio-WES is recommended following normal karyotyping and CMA results because it can improve the diagnostic utility of genetic variants of fetal dextrocardia, accurately predict fetal prognosis, and guide perinatal management and the reproductive decisions of affected families.

Background Dextrocardia with atrial fibrillation (AF) complicates radiofrequency ablation treatment. Methods A case of successful AF ablation in dextrocardia, guided by intracardiac echocardiography (ICE) and the Carto 3 high‐density mapping system, is reported. Results ICE‐guided transseptal puncture and three‐dimensional mapping facilitated successful pulmonary vein isolation (PVI). The patient had a good recovery with no recurrence. Conclusion ICE and Carto 3 system's high‐density mapping aid in ablation for abnormal cardiac anatomy, reducing surgical complications. A patient with dextrocardia and atrial fibrillation successfully underwent radiofrequency ablation under the guidance of intracardiac echocardiography.

The incorporation of transesophageal echocardiography (TEE) into cardiac arrest management overcomes several limitations inherent to transthoracic echocardiography, while producing higher-quality images. Among other advantages, TEE can evaluate chest compression quality and location during ongoing compressions. AHA/ACLS guidelines recommend hand placement for compressions over the lower half of the sternum in order to compress the left ventricle (LV). However, literature demonstrates that chest compressions do not align with the LV over half the time, but rather lie over the left ventricular outflow tract and aortic root. Under those circumstances, the LV is compressed inadequately. The inadequate stroke volume reduces the likelihood of obtaining return of spontaneous circulation. Additionally, the aortic valve would be compressed and remain closed, which literature shows is associated with decreased survival. Furthermore, standard chest compression technique assumes typical cardiac anatomy. However, anatomical variations such as dextrocardia can render these compressions ineffective. Physicians would not be aware of conditions like these at the time of initiating cardiopulmonary resuscitation. Here, we present the first known case of cardiac arrest in which the TEE diagnosis of dextrocardia led to TEE-guided chest compressions, leading to improved markers of organ perfusion and ROSC.

We present a clinical case of mitral insufficiency in a 59-year-old patient with dextrocardia and complete transposition of the viscera. The patient underwent mitral valve posterior leaflet repair and annuloplasty. During the operation, a \"mirror inversion\" of the equipment and surgery team position was carried out. The special feature of the operation was due to the fact that the aorta and great vessels in the wound were mirror-image. The postoperative period proceeded without complications. Being aware of the patient's dextrocardia and hence organizing the surgical procedure appropriately, we could achieve good results in radical surgery for valvular heart disease.

Dextrocardia is a rare cardiac malposition that was first described in 1606. Mirror-image dextrocardia is characterized by a mirror-image change of the normal position of the heart. Most cases are accompanied by situs inversus viscerum, whereas only 3% to 10% of cases are associated with intracardiac anomalies. Valve surgery for acquired valvular lesions in patients with mirror-image dextrocardia with situs inversus is rare. Diagnosing situs anomalies in adults is important to prevent errors during surgical operations, emergency procedures, or interventional operations. In this report, we present two cases of mitral regurgitation in patients with mirror-image dextrocardia. One patient had mirror-image dextrocardia with subacute infective endocarditis and mitral regurgitation, and the other patient had mirror-image dextrocardia with mitral Carpentier type I regurgitation. In both patients, mitral valve repair was successfully performed using a transseptal approach.

Cases of patients complicated with dextrocardia who suffer from acute cerebral infarction with large vessel occlusion and receive emergency thrombectomy are particularly rare and have not been widely reported. This article aimed to increase the awareness and knowledge of these cases. We report the case of a patient with mirror-image dextrocardia who suffered from cerebral infarction with large vessel occlusion and received emergency thrombectomy. A male patient in his early 60s with dextrocardia had acute cerebral infarction with posterior circulation large vessel occlusion and underwent emergency thrombectomy. During the operation, the rapid confirmation of dextrocardia and use of flexible interventional instruments helped establish a pathway for blood flow. We used an intracranial thrombectomy stent and intracranial balloon dilation catheter to restore the cerebral blood supply. The Modified Rankin Scale score was 0 at 3 months after thrombectomy, indicating a good prognosis of the patient. Acute cerebral infarction with large vessel occlusion in patients with dextrocardia is extremely rare. Emergency thrombectomy is feasible to recanalize cerebral blood flow and give patients a chance to recover.

This research seeks to ascertain the prevalence and determinants of mirror-image dextrocardia in fetuses. With December 2022 as the reference point, we compiled colleted data on pregnant women who carried fetuses with mirror-image dextrocardia in Xi'an, Shaanxi Province: September-October 2022, November 2022, and December 2022-January 2023. An online questionnaire was distributed to 209 pregnant across China who had contracted COVID-19. The case group comprised women whose final menstrual cycle occurred in November 2022 and who had a fetus with mirror-image dextrocardia. Women with a November 2022 final menstrual period and a fetus without this condition made up the control group. To identify the risk factors associated with fetal mirror-image dextrocardia, both univariate and multivariate logistic regression analyses were employed. A significant difference was noted in the gestational age at COVID-19 infection women with a September to October 2022 and December 2022 to January 2023 final menstrual period who did not bear a fetus with mirror-image dextrocardia, and those with a November 2022 final menstrual period whose fetus exhibited this condition. The univariate and multivariate analyses conducted on pregnant women with a final menstrual period in November 2022 who had contracted COVID-19 revealed significant differences in the presence and duration of fever between those bearing fetuses with mirror-image dextrocardia and those without ( = 0.000). The findings suggest two critical factors to the increased prevalence of fetal mirror-image dextrocardia: 1) the infection timing which occurs between the 4th and 6th week of pregnancy and 2) the presence of fever and its prolonged duration.

Mirror-image dextrocardia is a rare congenital cardiovascular disease in which the main part of the heart is located on the right side of the thoracic cavity, with the tip of the heart pointing to the right side and the positions of the ventricles, atria, large arteries, and veins resembling those of a normal heart. The case of mirror-image dextrocardia combined with atrial septal defect, moderate tricuspid valve insufficiency, and moderate to severe pulmonary hypertension is even rarer. A case of mirror-image dextrocardia combined with atrial septal defect, moderate tricuspid insufficiency, and moderate to severe pulmonary hypertension that was discharged from the hospital after surgical treatment is reported as follows.

The atrial switch procedure by Senning or Mustard technique primarily aims in correcting parallel systemic and pulmonary circulations at atrial level. This procedure may be used in late presenting D-transposition of great arteries with a deconditioned left ventricle, congenitally corrected transposition of great arteries and isolated ventricular inversion. We describe the case of a child with dextrocardia, left atrial isomerism with complex pulmonary and systemic venous drainage resulting in mixing at atrial level. She was successfully operated by modified Senning procedure performed through the left-sided atrium.