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Updated: Aug 10, 2025
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Total arterial revascularization in a case of dextrocardia with situs inversus
Azhar Sayyed1, Shreyas Potdar1, Ishan Zaidi2
1Department of Cardiac Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Narayana Health, 124, EM Bypass, Mukundapur, Kolkata 700099 India.
Insights
Dextrocardia with situs inversus presents unique challenges for coronary artery disease diagnosis and surgical revascularization. This case highlights successful total arterial revascularization using off-pump coronary artery bypass grafting.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Imaging
Background:
- Coronary artery disease (CAD) in patients with dextrocardia and situs inversus complicates standard diagnostic and treatment protocols.
- Surgical management requires careful consideration of anatomical variations and revascularization strategies.
Observation:
- A patient with dextrocardia and situs inversus presented with coronary artery disease.
- The condition posed significant challenges in diagnosis and surgical planning.
Findings:
- Total arterial revascularization was successfully performed using the off-pump coronary artery bypass (OPCAB) technique.
- Key surgical decisions included conduit selection (right internal thoracic artery vs. left internal thoracic artery) and optimal surgeon positioning.
Implications:
- This case demonstrates the feasibility of OPCAB in complex dextrocardia patients.
- Effective management strategies can be developed for these rare anatomical variations in CAD.
- Further research into optimizing surgical approaches for situs inversus patients is warranted.
Abstract:
Dextrocardia and situs inversus with coronary artery disease poses unique challenges with respect to presentation and diagnosis. From a surgical point of view, the main decision-making revolves around the strategy of revascularization: the choice of right internal thoracic artery or the left internal thoracic artery for the left anterior descending artery anastomosis, the operating surgeon standing on the left or the right side of the operating table, and the choice of arterial or venous conduits. We report a case of total arterial revascularization using off pump coronary artery bypass technique in a case of dextrocardia with situs inversus using We discuss the various challenges involved in the diagnosis and management.
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