Off-pump quintuple coronary artery bypass grafting for situs inversus totalis

Area of Science:

• Cardiovascular Surgery
• Congenital Heart Disease
• Thoracic Surgery

Background:

• Dextrocardia with situs inversus totalis is a rare congenital condition where the heart is on the right side of the chest.
• Coronary artery bypass grafting (CABG) is a common surgical procedure to treat coronary artery disease.
• Performing CABG in patients with situs inversus totalis presents unique anatomical challenges.

Observation:

• A 49-year-old male patient diagnosed with dextrocardia and situs inversus totalis presented with coronary artery disease.
• The patient underwent off-pump quintuple coronary artery bypass grafting.
• Surgical strategy utilized bilateral internal thoracic arteries and bilateral radial arteries, mirroring techniques used in situs solitus patients.

Findings:

• The off-pump coronary artery bypass grafting procedure was technically feasible and successfully completed in this patient with dextrocardia and situs inversus totalis.
• The operative approach demonstrated adaptability, utilizing standard off-pump CABG principles despite the atypical anatomy.
• Postoperative recovery for the patient was uneventful, indicating successful surgical intervention.

Implications:

• This case highlights the feasibility and safety of performing complex cardiac surgeries like off-pump CABG in patients with dextrocardia and situs inversus totalis.
• The findings suggest that standard surgical techniques can be adapted for these rare anatomical variations.
• Successful outcomes in such cases expand the surgical options for patients with congenital heart malformations and coronary artery disease.