Womens Hot Spots Halter Underwired Bikini Top Pour Moi Lowest Price Sale Online Low Cost Cheap Price Affordable For Sale Pre Order Sale Wholesale Price cCRzivpPB

SKU42913528693453
Womens Hot Spots Halter Underwired Bikini Top Pour Moi? Lowest Price Sale Online Low Cost Cheap Price Affordable For Sale Pre Order Sale Wholesale Price cCRzivpPB
Womens Hot Spots Halter Underwired Bikini Top Pour Moi?
The University of Texas at Austin
Raoul Woman Crepe De Chine Mini Dress Royal Blue Size 38 Raoul Geniue Stockist Cheap Online pY4Ud62k
Arlo Floralprint Silktwill Dress White Biyan Visit Online Eastbay Cheap Online Clearance Clearance Store High Quality Cheap Price JVAf6Kx8
Menu
Advertisement
For UK healthcare professionals only
This website is intended for UK healthcare professionals only Womens Biopromise Slimming String Hw Full Slip Scala Discount Fashion Style Shopping Discounts Online Cheap For Sale Sale 2018 Newest 5BLlCQ7eOo
| Burning Logo long dress Palm Angels Recommend Sale Online Outlet Sneakernews For Sale 2018 Cheap Buy Fashionable For Sale cAZQt

Tushar Raina Specialist Registrar in Cardiology

Ever D Grech Consultant Cardiologist

David Cumberland Consultant in Cardiac Intervention

South Yorkshire Cardiothoracic Centre, Northern General Hospital, Herries Road, Sheffield, S5 7AU

Correspondence to: Dr T Raina TOPWEAR Tshirts VETEMENTS Cheap Shop cfVBd

Dextrocardia is a rare anomaly with an estimated prevalence of about one in 10,000. The incidence of coronary artery disease is the same as in the general population. We report two cases of successful percutaneous treatment of coronary stenoses and aim to highlight some of the additional technical challenges that such patients present to the Interventional Cardiologist.

Case report 1

A 51-year-old man with known dextrocardia presented with a 12-month history of angina and an early positive exercise electrocardiogram (ECG). His risk factors were hypertension, hyperlipidaemia and cigarette smoking. Physical examination revealed a right-sided apex beat and chest radiography confirmed the presence of dextrocardia.

A 12-lead ECG ( figure 1 ) showed sinus rhythm with a reduction in the R-wave voltage in the standard chest leads and a corresponding increase in the right-sided leads.

Coronary angiography of the left coronary system (right sided) revealed minor non-flow limiting disease. The morphologic right coronary artery (left sided) however, revealed a severe discrete stenosis ( figure 2A ) in the mid-vessel. Following a review of the coronary anatomy, percutaneous intervention was planned for a subsequent sitting.

The procedure was performed using a 6 French AL-2 guide catheter and a high-torque, extra support guidewire. The lesion was directly stented with a 3.5 x 18 mm Zeta stent (Guidant). An excellent angiographic result was obtained ( figure 2B ) and there were no complications.

Case report 2

An 84-year-old woman with known dextrocardia was transferred from one of our referring hospitals with early post infarct unstable angina following an anterior ST elevation myocardial infarction for which she had received thrombolytic therapy.

Her risk factors were hypertension, hyperlipidaemia and previous smoking habit. Physical examination revealed findings consistent with situs inversus. A 12-lead ECG with leads reversed appropriately for dextrocardia, revealed well-controlled atrial fibrillation with widespread T wave inversion in the anterior chest leads. Chest radiography showed dextrocardia with a right-sided aortic knuckle as well as a right-sided gastric air bubble. Echocardiography confirmed a normal cardiac structure with impairment of left ventricular systolic function and evidence of hypokinesia in the antero-septal left ventricular territory.

Coronary angiography of the morphologic left coronary system (right sided) revealed a subtotally occluded proximal left anterior descending artery ( figure 3A ) and a left circumflex artery that was free of disease. The anatomical right coronary artery (left sided) revealed a moderate stenosis in a small-calibre distal posterior descending artery.

A decision was made to proceed to percutaneous revascularisation of the left anterior descending artery at the same sitting. The procedure was performed using a 6 French JL 3.5 guide catheter and Galeo medium guidewire. The subtotally occluded proximal left anterior descending artery was sequentially pre-dilated using 1.5 and 2.0 mm balloon catheters prior to deployment of a 2.5 x 20 mm paclitaxel-coated Taxus stent (Boston Scientific). This resulted in an excellent angiographic appearance ( figure 3B ) and there were no complications.

Discussion

The first cardiac catheterisation in dextrocardia was reported in 1973, the first coronary artery bypass surgery in 1980 and the first percutaneous intervention in dextrocardia was performed in 1987. There have since been a few reports of percutaneous treatment of coronary stenoses in dextrocardia patients.

Performing percutaneous coronary intervention in patients with dextrocardia presents several challenges to the interventional cardiologist. These include selection of appropriate diagnostic and interventional catheters, acquisition of modified interventional views and in some cases mirror image visualisation using image reversal software.

Conflict of interest

None declared.

References

Leave a Reply

You must be logged in to post a comment.

Not yet a member? Register now for free.

back to top

November 2017 Br J Cardiol 2017;24:129

REDUCE shows non-inferiority of short versus long DAPT in acute coronary syndrome

October 2017

ESC 2017: RE-DUAL PCI shows benefits for dabigatran

November 2016 Br J Cardiol 2016;23:155–8

Risk factors for femoral arterial complications and management

April 2016 Br J Cardiol 2016;23:78

Cheap Comfortable TOPWEAR Polo shirts Jaggy Free Shipping Recommend 2018 Cheap Online Best Place Sale Online Online For Sale NppGF

BJC LEARNING

Potassium and the heart

BJC LEARNING

Heart failure

Cardiorenal Forum 2017

Hyperkalaemia debate

Supplement

Perspectives in chronicheart failure treatment

BJC LEARNING

Anticoagulation

Advertisement

For healthcare professionals only

Advertisement

For healthcare professionals only

Advertisement

@BrJCardiol

Womens Konfektionshose Hanna 88994516 Straight Trousers More amp; More Buy Cheap Low Shipping Fee Shop Sale Online 8OQ71
very useful to learn about BNP and cardiac investigations

jaikrishnan | July 9, 2018 On article Heart failure module 2: diagnosis

Support Aeon

‘Your articles are smart, well written, and enriching. This is what intelligentsia is about.’

Dien H, USA, Friend of Aeon

Aeon is a registered charity committed to the spread of knowledge and a cosmopolitan worldview. But we can’t do it without you.

Ebay Cheap Price Flirty Romper in Pink size M also in L Lolli Swim Good Service Cheap Sale Explore Cheap Footaction oidvPW

Aeon is a registered charity committed to the spread of knowledge and a cosmopolitan worldview. Our mission is to create a sanctuary online for serious thinking.

No ads, no paywall, no clickbait – just thought-provoking ideas from the world’s leading thinkers, free to all. But we can’t do it without you.

Close

Become a Friend of Aeon to save articles and enjoy other exclusive benefits

Support Aeon

Subscribe to our newsletter

Updates on everything new at Aeon.

Newsletter Privacy Policy

Aeon email newsletters are issued by the not-for-profit, registered charity Aeon Media Group Ltd (Australian Business Number 80 612 076 614). This Email Newsletter Privacy Statement pertains to the personally identifying information you voluntarily submit in the form of your email address to receive our email newsletters

More generally, when visiting the Aeon site you should refer to our site Privacy Policy .

This Email Newsletter Privacy Statement may change from time to time and was last revised 5 June, 2018.

By clicking ‘Subscribe’ you agree to the following:

Unsubscribing

You can change your mind at any time by clicking the ‘unsubscribe link’ in the footer of emails you receive from us, or by contacting us at Asymmetric embroidered blouse Self Portrait Clearance Prices Free Shipping Pay With Paypal Kx9OAx

If you want to review and correct the personal information we have about you, you can click on ‘update preferences’ in the footer of emails you receive from us, or by contacting us at support@aeon.co

Security of your personal information

We are committed to ensuring that your information is secure. We have taken reasonable measures to protect information about you from loss, theft, misuse or unauthorised access, disclosure, alteration and destruction. No physical or electronic security system is impenetrable however and you should take your own precautions to protect the security of any personally identifiable information you transmit. We cannot guarantee that the personal information you supply will not be intercepted while transmitted to us or our marketing automation service Mailchimp.

Sharing your personal information

We will not disclose your personal information except: (1) as described by this Buy Cheap Fast Delivery Footaction Online Swim Shorts Slim Fit Small Logo in Green Shady green Original Penguin HtUWL
(2) after obtaining your permission to a specific use or disclosure or (3) if we are required to do so by a valid legal process or government request (such as a court order, a search warrant, a subpoena, a civil discovery request, or a statutory requirement). We will retain your information for as long as needed in light of the purposes for which is was obtained or to comply with our legal obligations and enforce our agreements.

Equipment Woman Tasseled Washedsilk Blouse White Size M Equipment Best Prices For Sale Clearance Limited Edition Real Sale Online XF1c3X4f

800.215.2776

1146 19th Street, NW Suite 400 Washington, DC 20036

Contact Us

Service Providers
About Us
Resources