Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2022; 10(4): 1357-1365
Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1357
Left atrial appendage occlusion in a mirror-image dextrocardia: A case report and review of literature
Bei Tian, Chuang Ma, Jin-Wen Su, Jun Luo, Hong-Xia Sun, Jie Su, Zhong-Ping Ning
Bei Tian, Jin-Wen Su, Jun Luo, Hong-Xia Sun, Zhong-Ping Ning, Zhoupu Hospital Shanghai University of Medicine & Health Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
Chuang Ma, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
Jie Su, Shache County People's Hospital, Kashgar 200437, Xinjiang Uygur Autonomous Region, China
Author contributions: Ning ZP supervised the team efforts; Tian B, Sun HX, and Luo J served as the surgical nurses; Tian B and Su J performed the data review and provided guidance on preparation of the case report; Tian B performed the video production; Tian B, Ma C, and Su J performed the data collection and writing of the manuscript.
Supported by Pudong New Area Science and Technology Development Fund Livelihood Scientific Research Project: Medical and Health, No. PKJ2020-Y106; Shanghai Pudong New District Medical Discipline Construction Project C Cardiovascular Internal Medicine Clinical Plateau Discipline, No. PWYgy2018-03; Shanghai Key Medical Specialty Construction Project, No. ZK2019B25; and Scientific Research Project of Shanghai Municipal Health and Family Planning Commission (Youth Project), No. 20184Y0230.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Ping Ning, MD, Chief Physician, Zhoupu Hospital Shanghai University of Medicine & Health Sciences, Shanghai University of Traditional Chinese Medicine, No. 650 South Wanping Road, Shanghai 200437, China. ningzhongping88@163.com
Received: August 11, 2021
Peer-review started: August 11, 2021
First decision: September 2, 2021
Revised: September 22, 2021
Accepted: December 23, 2021
Article in press: December 23, 2021
Published online: February 6, 2022
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

The procedure was uneventful and proceeded without complications. Anxiety symptoms were improved.

Keywords: Atrial fibrillation, Dextrocardia, Left atrial appendage occlusion, Music therapy, Enhanced recovery after surgery, Case report

Core Tip: Mirror dextrocardia has typical clinical characteristics. Because of the high prevalence and mortality of atrial fibrillation of patients with mirror dextrocardia, left atrial appendage occlusion has an important role in treatment, which continues to be confirmed. Left atrial appendage occlusion is an ideal choice for patients with atrial fibrillation. Moreover, music therapy can be used throughout perioperative treatment and nursing to improve the anxiety symptoms of patients.