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Updated: Jun 8, 2026
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Minimally-invasive coronary surgery in dextrocardia and situs inversus totalis
Gianpaolo Romano1, Gustavo Guida, Estefania De Garate
1Department of Cardiovascular Surgery and Transplants, V. Monaldi Hospital, Via L. Bianchi, 80131 Naples, Italy. gianpilotto@gmail.com
Insights
Dextrocardia with complete situs inversus, a rare condition, presents unique challenges for cardiac surgery. This case demonstrates successful coronary artery bypass grafting in such a patient.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Thoracic Surgery
Background:
- Dextrocardia associated with situs inversus totalis is a rare congenital condition affecting approximately 1 in 10,000 individuals.
- Patients with this condition typically have normal life expectancy and similar risks for ischemic heart disease as the general population.
- Surgical planning for cardiac procedures requires careful consideration of the atypical anatomy.
Observation:
- A 59-year-old female patient presented with single-vessel obstructive coronary artery disease.
- The patient had dextrocardia and complete situs inversus, meaning her heart and major organs were mirror images of their usual positions.
- Standard surgical approaches may be complicated by this anatomical variation.
Findings:
- The patient underwent successful coronary artery bypass grafting (CABG).
- The surgery was performed using a right anterior small thoracotomy approach.
- A beating-heart technique was employed, utilizing the right internal thoracic artery as a conduit for the 'left' anterior descending coronary artery.
Implications:
- This case highlights the feasibility and success of minimally invasive cardiac surgery in patients with dextrocardia and situs inversus totalis.
- It underscores the importance of adapting surgical techniques to accommodate rare congenital anomalies.
- Successful surgical outcomes in these patients can lead to improved quality of life and longevity.
Abstract:
Dextrocardia associated to situs inversus totalis is a rare congenital conditions (prevalence of 1:10,000) in which the organs are located in a symmetric or mirror position in the opposite side of the body. These individuals usually have a normal life expectancy and the same propensity to develop ischaemic coronary disease as the general population. We report a case of a 59-year-old female patient with a single-vessel obstructive coronary disease successfully resolved via a right anterior small thoracotomy on a beating-heart using the right internal thoracic artery as a conduit for 'left' anterior descending coronary artery.
