Pham CV, Nguyen DH, Vo AT, Nguyen TT, Phan LH, Nguyen BH. Minimally invasive mitral valve replacement and concomitant Cox-Maze IV procedure using radiofrequency energy in situs inversus totalis: A case report.
Int J Surg Case Rep 2020;
73:285-288. [PMID:
32721890 PMCID:
PMC7388168 DOI:
10.1016/j.ijscr.2020.07.053]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 11/10/2022] Open
Abstract
Cardiac surgery in a patient with situs inversus totalis poses technical challenges.
CT 3D-reconstruction helps operative planning.
Minimally invasive approach is safe and effective for patients with SIT.
Introduction
Situs inversus totalis (SIT) is an uncommon congenital condition characterized by total transposition of abdominal and thoracic viscera. Performing minimally invasive cardiac surgery on individuals with SIT requires different surgical planning because of the unfamiliar positions of the heart and great vessels.
Presentation of case
A 52-year-old female was admitted to our center with palpitations and dyspnea on exertion. Chest X-ray showed dextrocardia. Echocardiography and chest computerized tomography (CT) revealed SIT with severe rheumatic mitral valve disease.
Discussion
Pre-operative three-dimensional (3D) chest CT reconstruction was helpful in surgical planning and management of cardiopulmonary bypass (CPB). Mitral valve replacement and concomitant atrial fibrillation (AF) ablation using radiofrequency (RF) energy via left mini-thoracotomy was successfully performed on the patient.
Conclusion
Minimally invasive approach can be safely and effectively employed in patients with SIT.
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