08 June 2019
: Case report
Coronary Artery Bypass Grafting in a Patient with Situs Inversus Totalis
Rare disease
Konstantin Zhigalov1ABCDEF*, Danil Ponomarev2BEF, Artem Sozkov2BEF, Bakitbek Kadyraliev2BEF, Jerry Easo1BEF, Alexander Weymann1ABCDEFDOI: 10.12659/AJCR.916250
Am J Case Rep 2019; 20:806-809
Abstract
BACKGROUND: We report a rare case of total arterial coronary artery bypass grafting (CABG) in a patient with situs inversus totalis (SIT). SIT is a rare variant of biologically normal anatomy, in which the main internal organs are mirrored compared to normal localization.
CASE REPORT: A 50-year-old patient with SIT and severe coronary stenosis of the left anterior descending artery (LAD) and the ramus circumflexus (RCX) was admitted to our hospital. CABG was performed promptly using 2 conduits. After medial sternotomy, both mammary arteries were isolated by the skeletal method. Next, the cannulation of the aorta and the physiologically right atrium was performed. Custodiol cardioplegia was performed antegrade in a single shot. The left internal mammary artery (LIMA) was anastomosed to the LAD and the right internal mammary artery (RIMA) to the RCX. The aortic clamping time was 29 minutes. The operation was completed without complications. The patient was extubated 6 hours after surgery. On the first postoperative day, the patient was transferred to a regular ward. Postoperative therapy was performed without complications.
CONCLUSIONS: Surgical correction is indicated for many patients with SIT in combination with coronary heart disease. Performing a CABG operation on these patients requires the operating team to have certain skills. Surgeons face a number of problems and issues: preoperative preparation of the patient, the position of the surgeon to the left or right during the operation, the choice of conduit for anastomosis, and the tactics of the operation.
Keywords: Coronary Artery Bypass, Coronary Disease, Dextrocardia, Coronary Angiography, Coronary Stenosis, Follow-Up Studies, Rare Diseases, Risk Assessment, Situs Inversus, sternotomy, Tomography, X-Ray Computed
In Press
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.946669
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.946800
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.947628
Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.947148
Most Viewed Current Articles
21 Jun 2024 : Case report
97,828
DOI :10.12659/AJCR.944371
Am J Case Rep 2024; 25:e944371
07 Mar 2024 : Case report
52,727
DOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
20 Nov 2023 : Case report
32,839
DOI :10.12659/AJCR.941424
Am J Case Rep 2023; 24:e941424
18 Feb 2024 : Case report
23,613
DOI :10.12659/AJCR.943030
Am J Case Rep 2024; 25:e943030