Situs inversus and myocardial revascularization. Case report

Area of Science:

• Cardiovascular Surgery
• Congenital Conditions
• Interventional Cardiology

Background:

• Internal mammary artery (IMA) grafting is a standard procedure for coronary artery bypass surgery.
• Situs inversus totalis is a rare congenital condition where major visceral organs are mirrored.
• The incidence of atherosclerotic coronary artery disease is similar in patients with situs inversus totalis compared to the general population.

Observation:

• A patient presented with unstable postinfarction angina pectoris.
• The patient was diagnosed with situs inversus totalis, a complete reversal of thoracic and abdominal organ positions.
• Coronary angiography revealed significant disease in the anterior descending coronary artery.

Findings:

• Successful internal mammary artery (IMA) bypass grafting was performed to the anterior descending coronary artery.
• This represents the second reported case of coronary artery bypass surgery utilizing an IMA graft in a patient with situs inversus totalis.
• The surgical team navigated the anatomical variations presented by situs inversus totalis.

Implications:

• This case demonstrates the feasibility and success of IMA grafting in complex anatomical variations like situs inversus totalis.
• It expands the understanding of surgical management options for coronary artery disease in patients with congenital conditions.
• Further case studies may elucidate best practices for managing coronary artery disease in situs inversus patients.