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Interact Cardiovasc Thorac Surg. 2010 Dec;11(6):822-4. doi: 10.1510/icvts.2010.244673. Epub 2010 Sep 19.

Off-pump Y-graft coronary artery bypass in a patient with situs inversus totalis.

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Thoraxcenter, Medisch Spectrum Twente, Haaksbergerstraat 55, PO Box 50 000, 7500 KA Enschede, The Netherlands.


Situs inversus is the mirror image of situs solitus. Situs inversus with dextrocardia is termed 'situs inversus totalis'. Since situs inversus totalis is a rare condition, there are a only a few reports about off-pump coronary artery bypass (OPCAB) in these patients. A 67-year-old man with a diagnosis of situs inversus totalis and three-vessel disease, underwent an elective surgical revascularization. The operation consisted of an OPCAB using a total arterial composite Y-graft. The right internal mammary artery (RIMA) and the left radial artery (RA) were harvested as pedicles and they were anastomized as Y-grafts. Three distal anastomoses were performed: the RIMA to the anterior descending artery and the RA sequentially to the obtuse marginal branch and the posterior descending artery. The peculiarity of OPCAB no-touch with a composite graft in a patient with situs inversus totalis consisted in the mirroring of the whole surgical set-up and of the surgical strategy. The surgery as well as the postoperative period were uneventful. This case report shows the feasibility of OPCAB 'no-touch' with composite arterial grafting in a patient with situs inversus totalis.

[Indexed for MEDLINE]

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