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Abstract Background Mirror dextrocardia (MDC) is a condition in which the heart is located in a mirror-image position on the right side of the chest compared to the normal position in individuals with physiological variations. Patients with MDC and chronic total occlusion (CTO) of the left circumflex branch (LCX) are extremely rare in clinical practice. The treatment of MDC-CTO-LCX differs significantly from patients without mirror dextrocardia and the same condition in terms of instrument selection and procedural techniques. In this article, we report a successful case of interventional treatment in a patient with MDC-CTO-LCX. We summarize the anatomical and electrocardiographic variations in patients with MDC-CTO-LCX, and discuss the selection of interventional instruments and techniques that can be useful for interventionists as well as the diagnostic and therapeutic considerations that can be helpful for clinical physicians. Case presentation A male Han Chinese patient, 51, was admitted, presenting recurrent chest pain for a year and recent onset of exertional fatigue over the past week.He reported episodes of chest pain following physical activities over the past year, lasting between 5 and 20 min.Despite these symptoms, the patient did not seek immediate medical attention, and the occurrence of his chest pain has progressively lessened within the year.A week prior, the patient developed exertional dyspnea after brief walks, though without any episodes of nocturnal paroxysmal dyspnea.Upon arrival at our hospital for evaluation, he was initially diagnosed with chronic coronary syndrome, previous inferior myocardial infarction, atrial arrhythmia, and classified under the New York Heart Association functional class III.Following his admission, a chest X-ray and coronary angiography were conducted.The results indicated mirror dextrocardia and total occlusion of the left circumflex branch. Percutaneous coronary intervention (PCI) was performed on the left circumflex branch. Subsequent angiography demonstrated optimal stent positioning without evidence of hematoma or dissection.Following the procedure, the patient's symptoms of chest pain and exertional dyspnea were resolved, which led to his subsequent discharge.A follow-up electrocardiogram, 10 months post-procedure, displayed a slow and regular atrial rhythm. Conclusions The incidence of dextrocardia is very low, and it may appear normal on an electrocardiogram; however, careful diagnosis is required when there is an abnormal direction of the P wave in limb leads. During the operation for chronic occlusive lesions of the right-sided coronary artery, the anomalous anatomical structure necessitates specific requirements for instrument selection and operative techniques. After revascularization of chronic occlusive vessels in dextrocardia, routine electrocardiographic examination may show false normalization, requiring caution in interpretation.

To address the problems of high fuel consumption and severe traffic congestion caused by blindly cruising, we propose a Gurobi optimization algorithm combined with an A ngle and an A* algorithm (A2-Gurobi) to recommend the optimal taxi route based on big taxi trajectory data in the complex urban road network. Specifically, a r oad n etwork n ode e xtraction method (RNNE) based on the GPS direction of taxis is put forward to solve the difficulty of extracting road network nodes from the big Taxi GPS trajectory data. Next, an a ngle-based s harp p oint e limination approach (ASPE) is constructed to optimize the searching capability of the Gurobi algorithm to find the shortest path. Then, a Gurobi optimization algorithm (A-Gurobi) based on the A* algorithm is designed, which uses the heuristic function of the A* algorithm to enhance the ability of fast guidance from the origin to the destination, thereby improving the execution efficiency of the Gurobi algorithm. Finally, the A2-Gurobi algorithm is successfully applied to the optimal taxi route recommendation with real-world taxi trajectory big data. Compared with Gurobi, Dijkstra, Floyd, A*, Bi-A*-ACO, Bellman-Ford, BFS, Acyclic, and AC on the taxi trajectory data sets composed of 10, 20, 30, 40, and 50 nodes, the experimental results indicate that the distance of the A2-Gurobi algorithm for taxi route recommendation is 19.06%, 20.97%, 3.03%, 15.07%, 15.07%, and 3.85% shorter than that of Gurobi, A*, Bi-A*-ACO, BFS, Acyclic, and AC on average, respectively, and it also achieves the same distance as other algorithms. In terms of execution efficiency, our A2-Gurobi algorithm outperforms the baselines mentioned above by 38.56%, 96.63%, 66.66%, 66.66%, 90.87%, 97.60%, 97.27%, 97.21%, and 99.27%, respectively. [ABSTRACT FROM AUTHOR]