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Updated: Jul 13, 2025

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Outcomes of the Arterial Switch Operation in Patients With Dextrocardia
Kaushik Thungathurthi1, Tyson A Fricke2, Nick Fulkoski1
1Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Vic, Australia.
Background:
Patients with dextrocardia and d-transposition of the great arteries (d-TGA) present a technical challenge when performing the arterial switch operation (ASO). We sought to determine the long-term outcomes of this rare presentation.
Methods:
All patients who underwent the ASO with d-TGA and dextrocardia were identified from the hospital database.
Results:
There were four patients with dextrocardia (4 of 844, 0.5%) patients; two patients had situs solitus and two patients had situs inversus. Three patients had a ventricular septal defect. Left ventricular outflow tract obstruction was present in one patient and one patient had a hypoplastic arch with severe coarctation of aorta. Anomalous coronary anatomy occurred in two patients. There was one early mortality and the cause of death was sepsis. One patient required late reoperation for severe neo-pulmonary valve regurgitation at 23 years after the ASO. At last follow-up, all three surviving patients were in New York Heart Association Class I.
Conclusions:
Patients with d-TGA and dextrocardia who undergo the ASO are extremely rare and require challenging operative management.

