Balloon Mitral and Aortic Valvuloplasty in Mirror-Image Dextrocardia

Three patients of mirror-image dextrocardia were subjected to balloon valvuloplasty at our institute. One patient had severe pliable rheumatic mitral stenosis (MS), another had severe calcific rheumatic MS and the third had moderate rheumatic MS and severe rheumatic aortic stenosis (AS). Necessary modifications in the standard septal puncture technique, Inoue mitral valvuloplasty technique, and Cribier aortic valvuloplasty technique were done keeping unusual anatomy of mirror-image dextrocardia in account to dilate mitral and aortic stenosis successfully. Acute hemodynamic results were satisfactory and no complications encountered. This report illustrates feasibility and safety of balloon mitral and aortic valvuloplasty in the complex cardiac anatomy of situs inversus totalis.