Mitral and Tricuspid Valve Replacement in Uncommon Case of Situs Inversus with Dextrocardia
Keywords:
dextrocardia, hemoglobin H, rheumatic heart disease, situs inversusAbstract
Background: Incidence of congenital cardiac anomalies in dextrocardia with situs inversus combined with severerheumatic mitral valve stenosis (MS) and tricuspid regurgitation is uncommon. Also, anatomic malposition can cause
hindrance for surgeon while handling cannulation and diseased valves.
Objective: We reported a case of situs inversus and dextrocardia with rheumatic mitral stenosis and severe
tricuspid regurgitation. Details of diagnosis, treatment and some technical operative techniques to cope with this
condition were described and the literature review was performed.
Case report: The patient was a 48-year-old woman with a history of cardiomegaly, progressive dyspnea, easy
fatigability, paroxysmal nocturnaldyspnea, anasarca, marked jaundice and had the New York Heart Association
(NYHA) Class 3 with underlying hemoglobin H disease. She underwent mitral and tricuspid valve replacement due to
severe rheumatic mitral stenosis and tricuspid regurgitation. She was improved to NYHA Class 1 within two months
after the operation.
Conclusions: Based on this uncommon patient presenting with dextrocardia, the recommended primary
operative approach is performed with the surgeon standing at the left side of the patient. A transeptal-atriotomy
provided an excellent exposure without heart positioner.
References
1. Bharati S, Lev M. Positional variations of the heart and its
component chambers. Circulation 1979;59:886-7.
2. Bopp P, Bussat P, Lemonnier J. Rheumatic heart disease and
dextrocardia. Arch Intern Med 1964;113:19-22.
3. Keith J, Rowe R, Vlad P. Heart Disease in Infancy and Childhood.
New York: MacMillan Co; 1958.
4. Davies E, Duffy J, Kamdar H. Mitral valvulotomy in situsinversus
with associated skeletal anomalies. Br Heart J 1965;27:48-50.
5. Bohun CM, Potts JE, Casey BM, Sandor GG. A Populationbases
study of cardiac malformations and outcomes
associated with dextrocardia. Am J Cardiol 2007;100:305-9.
6. Owen SA. A case of complete transposition of the viscera,
associated with mitral stenosis, including a description of the
electrocardiographic tracings. Heart 2003;113:1911-2.
7. Garg N, Agarwal BL, Modi N, Radhakrishnan S, Sinha N.
Dextrocardia: An analysis of cardiac structures in 125 patients.
Int J Cardiol 2003;88:143-5.
8. Ji YQ, Sun PW, Hu JX. Diagnosis and surgical treatment of
congenital dextrocardia. Di Yi Jun Yi Da Xue Xue Bao 2002;
22:536-8.
9. Okaura H, Yamaguchi A, Adachi K, Adachi H. Mitral valve
replacement in case of dextrocardia with situssolitus. J Heart
Valve Dis 2010;9:794-6.
component chambers. Circulation 1979;59:886-7.
2. Bopp P, Bussat P, Lemonnier J. Rheumatic heart disease and
dextrocardia. Arch Intern Med 1964;113:19-22.
3. Keith J, Rowe R, Vlad P. Heart Disease in Infancy and Childhood.
New York: MacMillan Co; 1958.
4. Davies E, Duffy J, Kamdar H. Mitral valvulotomy in situsinversus
with associated skeletal anomalies. Br Heart J 1965;27:48-50.
5. Bohun CM, Potts JE, Casey BM, Sandor GG. A Populationbases
study of cardiac malformations and outcomes
associated with dextrocardia. Am J Cardiol 2007;100:305-9.
6. Owen SA. A case of complete transposition of the viscera,
associated with mitral stenosis, including a description of the
electrocardiographic tracings. Heart 2003;113:1911-2.
7. Garg N, Agarwal BL, Modi N, Radhakrishnan S, Sinha N.
Dextrocardia: An analysis of cardiac structures in 125 patients.
Int J Cardiol 2003;88:143-5.
8. Ji YQ, Sun PW, Hu JX. Diagnosis and surgical treatment of
congenital dextrocardia. Di Yi Jun Yi Da Xue Xue Bao 2002;
22:536-8.
9. Okaura H, Yamaguchi A, Adachi K, Adachi H. Mitral valve
replacement in case of dextrocardia with situssolitus. J Heart
Valve Dis 2010;9:794-6.
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Published
2014-12-29
How to Cite
1.
Arayawudhikul N. Mitral and Tricuspid Valve Replacement in Uncommon Case of Situs Inversus with Dextrocardia. Thai J Surg [Internet]. 2014 Dec. 29 [cited 2024 Jul. 18];35(4). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/226618
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