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J Thorac Cardiovasc Surg 2006;132:148-149
© 2006 The American Association for Thoracic Surgery

Brief Communication

Endoscopic redo tricuspid valve replacement in complete situs inversus

Ranjit P. Deshpande, MCh, FRCS (C-Th), Filip Casselman, MD, PhD, FETCS * , Anthony Vanermen, MD, Hugo Vanermen, MD, FETCS

Department of Cardiovascular & Thoracic Surgery, OLV Clinic, Aalst, Belgium

Received for publication February 13, 2006; accepted for publication February 22, 2006.

* Address for reprints: Filip P. Casselman, MD, PhD, FETCS, Department of Cardiovascular & Thoracic Surgery, OLV Clinic, 164 Moorselbaan, Aalst, Belgium 9300. (Email: filip.casselman@olvz-aalst.be).

The first 20% of the full text of this article appears below.

Clinical Summary

A 77-year-old woman with paroxysmal atrial fibrillation presented with right heart failure. She had a history of rheumatic mitral stenosis. Ten years earlier she had undergone mechanical mitral valve replacement via a sternotomy for mitral valve endocarditis. The chest x-ray film revealed dextrocardia (Figure 1, A). Transesophageal echocardiography confirmed dextrocardia with a normal mitral valve replacement, grade III tricuspid regurgitation with a tricuspid annulus diameter of 37 mm, a dilated right atrium (RA) with an impaired right ventricle, and a left ventricular ejection fraction of 65%. A contrast computed tomographic scan (Figure 1, B) and magnetic resonance imaging confirmed complete situs inversus with left-sided superior and inferior venae cavae (LSVC, LIVC) draining into a left-sided RA, atrioventriculoarterial concordance, and a right-sided descending aorta. The coronary arteries were normal, and right heart catheterization revealed severe tricuspid regurgitation, elevated RA pressure, and moderate pulmonary hypertension. Her calculated EuroSCORE was 10.


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  		Figure 1. Chest x-ray film (A) . . . [Full Text of this Article]

 





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