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[Simultaneous coronary artery bypass grafting and total arch graft replacement with dextrocardia and situs inversus]
1Department of Cardiovascular Surgery, Hokkaido Ohno Hospital, Sapporo, Japan.
Insights
This study details a complex aortic arch repair in a patient with dextrocardia and situs inversus. Surgical intervention successfully addressed ascending aorta dilatation and coronary artery stenosis.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Congenital Heart Disease
Background:
- The patient presented with sudden back pain, indicative of potential aortic pathology.
- Pre-existing dextrocardia and situs inversus presented unique surgical challenges.
- Significant findings included ascending aorta and aortic arch dilatation (5.6 cm) and right coronary artery stenosis (75%).
Abstract:
The patient was a 79-year-old male who complained a sudden back pain. He had dextrocardia and situs inversus. An aortogram showed the dilatation of the ascending and aortic arch which reached 5.6 cm in diameter. A coronary angiogram also showed the 75 percent stenosis of segment 3 in the right coronary artery. Coronary artery bypass grafting to the right coronary artery was performed using a saphenous vein graft during cooling stage of the extracorporeal circulation. After that total arch replacement was carried out using a graft with four side branches with an aid of selective cerebral perfusion. He complicated with respiratory failure postoperatively and needed tracheostomy but recovered gradually. A postoperative computed tomogram showed good patency of three side grafts for cerebral perfusion and no abnormality of graft anastomosis.