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Updated: Jul 14, 2026
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Myocardial revascularization in a patient with situs inversus totalis
Paulo Manuel Pego-Fernandes1, João Batista de Serro-Azul, Fernando Matheus
1Instituto do Coração, Hospital das Clínicas, FMUSP, São Paulo, SP, Brazil. paulopego@incor.usp.br
Insights
This case study details coronary artery bypass grafting surgery for a patient with dextrocardia and situs inversus totalis. The complex procedure involved extensive myocardial revascularization due to obstructive coronary artery disease.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Imaging
Background:
- Dextrocardia and situs inversus totalis are rare congenital conditions.
- Obstructive coronary artery disease requires timely intervention.
- Surgical management in patients with complex congenital anomalies presents unique challenges.
Observation:
- A patient with dextrocardia and situs inversus totalis presented with severe obstructive coronary artery disease.
- The coronary arteries affected included the anterior descending, posterior descending, right coronary, first diagonal, and left marginal branches.
Findings:
- Coronary artery bypass grafting (CABG) was successfully performed.
- Myocardial revascularization utilized the right mammary artery for the anterior descending artery.
- Saphenous vein grafts were used for the aorta-to-right coronary artery, left marginal branch, first diagonal branch, and posterior descending artery.
- The surgery was conducted using extracorporeal circulation.
Implications:
- This case highlights the feasibility of CABG in patients with dextrocardia and situs inversus totalis.
- Successful surgical outcomes underscore the importance of tailored approaches in complex cardiac cases.
- Further case reports are valuable for refining surgical strategies in rare congenital anomalies.
Abstract:
We report the case of a patient with dextrocardia and situs inversus totalis associated with obstructive coronariopathy in the anterior and posterior descending arteries, right coronary artery, first diagonal branch and left marginal branch. The patient underwent coronary artery bypass grafting surgery. This surgery has been rarely reported in literature and we found only one similar case in the national medical literature. The myocardial revascularization was carried out with the right mammary artery for the anterior descending artery. The saphenous vein anastomosed the aorta to the right coronary artery, left marginal branch, fist diagonal branch and posterior descending artery. The surgery was performed with extracorporeal circulation.
