title: [Mitral valve replacement in dextrocardia and situs inversus].
abstract: Cardiac surgery for acquired valvular diseases in patients with dextrocardia is extremely rare. We report a surgical case of mitral valve replacement and tricuspid annuloplasty in a patient with dextrocardia and situs inversus. A 74-year-old man with dextrocardia and situs inversus, who had undergone patch closure of atrial septal defect 25 years before, was referred for surgical treatment of severe mitral and tricuspid valve regurgitation. Preoperative computed tomography( CT) showed dextrocardia, situs inversus, interruption of the inferior vena cava with an azygos vein continuation, and drainage of the hepatic vein into the right atrium. Under redo-median sternotomoy, cardiopulmonary bypass was established by cannulating the ascending aorta, the superior vena cava, the right femoral and the hepatic veins. The surgeon operated from the left side of the operating table, and had an excellent exposure to the mitral and tricuspid valves during the operation. Mitral valve replacement and tricuspid annuloplasty were performed successfully. The postoperative course was uneventful.
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute, Fuchu, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Uchimuro
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Fukui
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Matsuyama
authors.forename: Minoru
authors.initials: M
authors.lastname: Tabata
authors.forename: Shuichirou
authors.initials: S
authors.lastname: Takanashi
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000379:methods; D002315:Cardiopulmonary Bypass; D003914:Dextrocardia / Q000150:complications*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery; D012857:Situs Inversus / Q000150:complications*; D014261:Tricuspid Valve / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000601:surgery