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You are here: Contents > 2010 > Volume 19 Number 6 November 2010 > CASE REPORTS > Mitral Valve Replacement in a Case of Dextrocardia with Situs Solitus

Mitral Valve Replacement in a Case of Dextrocardia with Situs Solitus

Homare Okamura, Atsushi Yamaguchi, Koichi Adachi, Hideo Adachi 

Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Omiya-ku, Saitama-shi, Saitama, Japan

Cardiac surgery in patients with a positional anomaly of the heart is technically challenging, and very few reports exist of such surgery in patients with dextrocardia. A 73-year-old woman in whom dextrocardia with situs solitus had been diagnosed at a young age, presented with palpitation and shortness of breath due to significant mitral valve insufficiency. Cardiopulmonary bypass (CPB) was initiated through aortic, superior vena cava, and inferior vena cava cannulae. The use of a heart positioner simplified and made safe the initiation of CPB. A left-sided

left atriotomy provided excellent exposure of the mitral valve, and mitral valve replacement (MVR) was safely performed with a 25 mm St. Jude Medical mechanical prosthesis. The postoperative course was uneventful. In patients with dextrocardia requiring cardiac surgery, it is important to consider the appropriate surgical strategy. Approaching the mitral valve through a left-sided left atrial incision seems to provide excellent exposure for MVR.

The Journal of Heart Valve Disease 2010;19:795-797

Mitral Valve Replacement in a Case of Dextrocardia with Situs Solitus

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