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Coronary artery bypass grafting in a patient with situs inversus totalis and dextrocardia
Eduardo Keller Saadi1, Luis Henrique Dussin, Alvaro Nicolao
1Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil. esaadi@terra.com.br
Insights
Situs inversus totalis, a rare congenital condition, was observed in a 78-year-old woman with ischemic coronary artery disease. Myocardial revascularization was successfully performed, marking a unique case with coronary aneurysms.
Area of Science:
- Cardiology
- Congenital Anomalies
- Surgical Procedures
Background:
- Situs inversus totalis is a rare congenital condition where major visceral organs are reversed.
- Ischemic coronary artery disease necessitates interventions like myocardial revascularization.
Observation:
- A 78-year-old woman presented with situs inversus totalis and ischemic coronary artery disease.
- Cardiac catheterization revealed severe proximal stenosis and aneurysms in coronary arteries.
Findings:
- Myocardial revascularization was performed with the surgical team positioned on the patient's left.
- The procedure involved anastomosing the right internal thoracic artery and vein grafts to coronary arteries.
Implications:
- This case represents the first reported instance of situs inversus totalis with coronary aneurysms worldwide.
- Successful surgical management highlights the feasibility of complex cardiac procedures in patients with situs inversus totalis.
- Adds to the limited global case reports of situs inversus totalis, particularly in Brazil.
Abstract:
Situs inversus totalis is a rare congenital anomaly. We report a case of a 78-year-old woman with this condition and ischemic coronary artery disease who underwent myocardial revascularization. The cardiac catheterism showed severe proximal stenosis with aneurysms in the anterior interventricular branch, diagonal artery, and right coronary artery. The procedure was done with the surgeon positioned in the left hand side of the patient, with the right internal thoracic artery anastomosed to the anterior interventricular branch, and to two more vein grafts. Very few cases have been reported in the world and this is the third case in Brazil, and the first in the world with coronary aneurysms.
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