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

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.

• Authors: Sara Camilla Arrigoni, Richard Oosterhof, Massimo Alessandro Mariani
• Journal: Interactive cardiovascular and thoracic surgery (Interact Cardiovasc Thorac Surg) Vol. 11 Issue 6 Pg. 822-4 (Dec 2010) ISSN: 1569-9285 [Electronic] England
• PMID: 20852333 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Coronary Artery Bypass, Off-Pump
• Coronary Artery Disease (complications, diagnostic imaging, surgery)
• Dextrocardia (complications, diagnostic imaging)
• Humans
• Internal Mammary-Coronary Artery Anastomosis
• Male
• Radial Artery (transplantation)
• Situs Inversus (complications, diagnostic imaging)
• Tomography, X-Ray Computed
• Treatment Outcome