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Published on: March 8, 2019
Morphometric characteristics of the aorta and heart in situs inversus totalis
Uliana Pidvalna1, Marianna Mirchuk1,2, Dmytro Beshley1,2,3
1Department of Normal Anatomy, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
Insights
Situs inversus totalis, a rare visceral transposition, requires detailed CT scans for surgical planning. Accurate vessel measurements ensure patient safety and predict complications during interventions.
Area of Science:
- Radiology
- Cardiovascular Surgery
- Anatomy
Background:
- Situs inversus totalis involves complete transposition of thoracic and abdominal organs.
- Preoperative computed tomography (CT) assessment is crucial for cardiovascular surgery.
Observation:
- A 74-year-old male with acute abdominal syndrome was incidentally diagnosed with situs inversus totalis.
- CT revealed significant cardiovascular variations requiring detailed morphometric analysis.
Findings:
- CT-based morphometric analysis precisely mapped vessel topography and dimensions.
- Accurate aortic measurements guided the selection of appropriate prosthesis size for repair.
- Vessel assessment informed catheter diameter choice and cannulation site selection, mitigating risks.
Implications:
- Detailed anatomical analysis in situs inversus totalis enhances surgical planning.
- Preoperative imaging is vital for avoiding vessel trauma and hemorrhage.
- Understanding anatomical variations improves patient safety and complication prediction in complex surgeries.
Abstract:
Situs inversus totalis is a rare condition of visceral transposition in thoracic and abdominal cavities. Computed tomography (CT)-based morphometric analysis of the cardiovascular system prior to the surgery helps to describe vessel topography and size, choose the right surgical insertion site, avoid vessel trauma, and prevent hemorrhage during surgical intervention. We present a case report of situs inversus totalis detected incidentally in a 74-year-old male with the acute abdominal syndrome. Appropriate detailed aorta measurements are used to choose an adequate size of the aortic prosthesis during open surgical repair or endovascular aneurysm repair. An accurate assessment of the vessels on CT scans assists in consideration of the catheter diameter and the most reliable cannulation site. Vessel size correlates with morphological conditions (kinking, stenosis, occlusion), which may be considered a risk of organ malperfusion. The anatomical analysis prior to surgery in different anatomical variations may ensure patient safety and predict complications.
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