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Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Satoshi YAMASHIRO, Ryoko ARAKAKI, Yuya KISE, Hitoshi INAFUKU, Yukio KUNIYOSHI
Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
Dextrocardia is generally defined as the heart being located in the right hemithorax. It is frequently associated with multiple complex congenital cardiac malformations and situs anomalies. Dextrocardia with polysplenia is one of a large spectrum of situs anomalies. A 67-year-old male with dextrocardia was admitted for treatment of congestive heart failure. A cardiac examination revealed severe mitral regurgitation secondary to prolapse of the posterior mitral valve leaflet and severe tricuspid valve regurgitation with an atrial septal defect. The situs anomalies were anatomically assessed in detail before surgery. Computed tomography revealed dextrocardia with a right-sided aortic arch, polysplenia, situs ambiguous, and an absent intrahepatic inferior vena cava with azygos continuation draining into a dilated left superior vena cava. The patient was treated by mitral and tricuspid valve repair, and the atrial septal defect was closed. Situs ambiguous is a congenital anomaly that is rare in adults. Mitral valve surgery in dextrocardia is technically challenging due to its anatomical malposition. Surgeons might need to make a few modifications to operate on patients with dextrocardia and ensure that they have a complete understanding and unequivocal description of the cardiac anatomy as a prerequisite for successful cardiac surgery.