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Just flip it!-CRT implantation in a patient with dextrocardia and situs inversus totalis.

ABSTRACT: Implantation of a cardiac resynchronization therapy (CRT) device in patients with congenital heart disease may be challenging because of the particular underlying anatomy. We present the case of a right-sided transvenous implantation of a dual-chamber CRT-D device in a patient with situs inversus totalis and mirror image dextrocardia. To facilitate our anatomic orientation and to overcome unusual hand-eye coordination problems, we decided to flip the fluoroscopic image projection by 180° (right-left), creating the optical impression of a "normalized" heart position (levocardia). This simple approach allowed us to successfully implant the device using a conventional left-sided CRT delivery system.

SUBMITTER: Steinberg C

PROVIDER: S-EPMC6288602 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Just flip it!-CRT implantation in a patient with dextrocardia and situs inversus totalis.

Steinberg Christian C Deyell Marc W MW Chakrabarti Santabhanu S

Journal of arrhythmia 20181006 6

Implantation of a cardiac resynchronization therapy (CRT) device in patients with congenital heart disease may be challenging because of the particular underlying anatomy. We present the case of a right-sided transvenous implantation of a dual-chamber CRT-D device in a patient with situs inversus totalis and mirror image dextrocardia. To facilitate our anatomic orientation and to overcome unusual hand-eye coordination problems, we decided to flip the fluoroscopic image projection by 180° (right- ...[more]

PMID: 30555613

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