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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.

Author information

1
Thoraxcenter, Medisch Spectrum Twente, Haaksbergerstraat 55, PO Box 50 000, 7500 KA Enschede, The Netherlands. s.arrigoni@mst.nl

Abstract

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.

PMID:
20852333
DOI:
10.1510/icvts.2010.244673
[Indexed for MEDLINE]

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