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Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
[Mitral valve replacement in dextrocardia and situs inversus]
Tomoya Uchimuro1, Toshihiro Fukui, Shigefumi Matsuyama
1Department of Cardiovascular Surgery, Sakakibara Heart Institute, Fuchu, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|September 4, 2012
Summary
This case report details successful cardiac surgery for severe mitral and tricuspid valve regurgitation in a patient with dextrocardia and situs inversus. The complex procedure involved valve replacement and annuloplasty, highlighting surgical adaptability.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Disease
- Cardiac Anatomy
Background:
- Dextrocardia with situs inversus presents unique challenges for cardiac surgery.
- Acquired valvular diseases in these patients are exceptionally rare.
- Previous atrial septal defect repair complicated the surgical planning.
Observation:
- A 74-year-old male with dextrocardia and situs inversus presented with severe mitral and tricuspid regurgitation.
- Preoperative imaging revealed complex venous anatomy, including interrupted inferior vena cava and hepatic vein drainage into the right atrium.
- The patient had a history of prior cardiac surgery for atrial septal defect.
Findings:
- Successful redo-median sternotomy was performed.
- Cardiopulmonary bypass was established using atypical cannulation sites (ascending aorta, SVC, femoral vein, hepatic vein).
- Mitral valve replacement and tricuspid annuloplasty were completed with excellent valve exposure by operating from the patient's left side.
Implications:
- This case demonstrates the feasibility of complex cardiac valve surgery in patients with dextrocardia and situs inversus.
- Adaptable surgical strategies and meticulous preoperative planning are crucial for managing complex venous anomalies.
- Successful outcomes are achievable despite anatomical variations, expanding treatment possibilities for rare conditions.
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