Total myocardial revascularization for situs inversus totalis with dextrocardia: a case report

Area of Science:

• Cardiovascular Surgery
• Congenital Heart Conditions

Background:

• Severe coronary artery disease presents complex surgical challenges.
• Situs inversus totalis with dextrocardia is a rare congenital condition where major visceral organs are reversed.
• Managing cardiac conditions in patients with dextrocardia requires tailored surgical approaches.

Purpose of the Study:

• To describe the surgical experience of performing coronary artery bypass grafting (CABG) in patients with situs inversus totalis and dextrocardia.
• To evaluate the feasibility and technique of using the right internal mammary artery (RIMA) in such cases.

Main Methods:

• Retrospective case report of two patients.
• Coronary artery bypass grafting performed with the surgeon positioned on the patient's right side.
• Harvesting and utilization of the right internal mammary artery (RIMA) as a graft.

Main Results:

• Successful completion of coronary artery bypass grafting in both patients.
• The RIMA was effectively utilized as a graft, demonstrating its viability in this anatomical variation.
• No immediate perioperative complications were reported.

Conclusions:

• Coronary artery bypass grafting is feasible in patients with situs inversus totalis and dextrocardia.
• The RIMA can be a suitable alternative graft when the left internal mammary artery is not ideal due to dextrocardia.
• This case series highlights the adaptability of surgical techniques for rare congenital anomalies.