Surgical Closure of Aortopulmonary Window in a Topsy-Turvy Heart: A Surgical Challenge

Topsy-turvy heart is a rare congenital cardiac anomaly characterized by a 90° rotation of the heart along its long axis. The great vessels originate posteroinferiorly, and the arch vessels are elongated and join the aorta well below the carina. It is usually associated with aortic arch and tracheobronchial anomalies. Cardiopulmonary bypass is challenging in these patients because of the abnormal position of the great vessels. We describe the surgical management of aortopulmonary window in a topsy-turvy heart in a 14-day-old girl.