Abstract
BackgroundAnesthetic management of coronary artery bypass grafting surgery (CABG) in a dextrocardia patient with situs inversus totalis is rarely encountered and seldom reported in the literature.Case presentationA 76-year-old Japanese female patient had been diagnosed with situs inversus totalis and coronary artery disease of 3 vessels, and she subsequently underwent elective CABG. A preoperative examination showed almost normal results. ECG showed right deviation with the normal lead position. In the operating room, ECG leads were applied in reverse. Pulmonary artery catheterization was performed via the left internal jugular vein. A transesophageal echocardiography (TEE) probe was introduced without difficulty. A different angle was needed to acquire the desired views because of her atypical anatomy.ConclusionCareful perioperative evaluation, intraoperative management, and inspection of multiplane angle and probe adjustments in TEE are needed for anatomically abnormal patients.
Highlights
Dextrocardia with situs inversus totalis is a very rare congenital abnormality characterized by the formation of all organs in the mirror image of the normal position, and it has an incidence rate of 1 in 10,000 [1]
Careful perioperative evaluation, intraoperative management, and inspection of multiplane angle and probe adjustments in transesophageal echocardiography (TEE) are needed for anatomically abnormal patients
Case report A 76-year-old Japanese female patient had been diagnosed with situs inversus totalis 30 years ago and had since experienced no symptoms of her condition
Summary
CABG in dextrocardia with situs inversus totalis can be managed without any complications. Intraoperative positioning of the heart, selection of conduits and graft configuration, multiplane angles, and probe adjustments in TEE are needed for these anatomically abnormal patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
