Left-sided surgical approach for tricuspid valve replacement in congenitally corrected transposition of the great arteries with dextrocardia and situs inversus totalis: A case report.
- 1Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing, 100029, China.
- 2Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing, 100029, China. [email protected].
- 3Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing, 100029, China. [email protected].
Abstract
Background
Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital cardiac anomaly characterized by atrioventricular and ventriculoarterial discordance, resulting in a physiologically corrected circulation. When ccTGA is combined with dextrocardia and situs inversus totalis, surgical management becomes particularly challenging because of the mirror-image anatomy and altered spatial orientation.Case presentation
A 61-year-old man presented with progressive dyspnea and was diagnosed with ccTGA accompanied by dextrocardia and situs inversus totalis. Transthoracic echocardiography revealed severe regurgitation of the systemic atrioventricular valve (morphological tricuspid valve) with dilation and systolic dysfunction of the systemic right ventricle. Comprehensive preoperative imaging confirmed atrioventricular and ventriculoarterial discordance, right-sided cardiac apex, and complete visceral inversion. Tricuspid valve replacement was performed via a median sternotomy with the surgeon standing on the patient's left side to accommodate the mirror-image anatomy. Cardiopulmonary bypass was established safely after meticulous identification of the great vessels. A mechanical prosthetic valve was successfully implanted. The postoperative course was uneventful, and follow-up echocardiography at six months confirmed satisfactory prosthetic valve function without complications.Conclusions
This case illustrates that tricuspid valve replacement can be safely and effectively performed in patients with ccTGA complicated by dextrocardia and situs inversus totalis. A left-sided surgical approach, combined with thorough preoperative imaging and careful intraoperative anatomical verification, may help restore operative orientation and reduce technical complexity in patients with mirror-image cardiac anatomy.
Related
- Case Report: Angiography-guided transvenous single-chamber pacemaker implantation in mirror-image dextrocardia with congenitally corrected transposition of the great arteries.
- Impaired Atrioventricular Conduction System in a Postoperative Heart With Congenitally Corrected Transposition of the Great Arteries
- Situs Inversus Totalis with Mirror-Image Dextrocardia and Acute Type A Aortic Dissection Treated by Ascending Aorta Replacement Plus Total Arch Replacement and Frozen Elephant Trunk Using an Inverted Four-Branched Graft: A Case Report
- Percutaneous closure of ruptured sinus of Valsalva and tricuspid paravalvular leak following surgical tricuspid valve replacement.
- Coexisting Moderate-to-Severe Tricuspid Regurgitation and Renal Dysfunction Identify a High-Risk Group After Transcatheter Aortic Valve Replacement
BibTeX
@article{yue2026leftsided,
title = {{Left-sided surgical approach for tricuspid valve replacement in congenitally corrected transposition of the great arteries with dextrocardia and situs inversus totalis: A case report.}},
author = {Chuanjie Yue and Tong Tan and Peng Sun and Jinhua Li and Changwei Ren and Yongqiang Lai and Hao Cui},
journal = {Journal of cardiothoracic surgery},
year = {2026},
month = jul,
doi = {10.1186/s13019-026-04150-5},
url = {https://europepmc.org/article/MED/42894230},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Left-sided surgical approach for tricuspid valve replacement in congenitally corrected transposition of the great arteries with dextrocardia and situs inversus totalis: A case report.
AU - Chuanjie Yue
AU - Tong Tan
AU - Peng Sun
AU - Jinhua Li
AU - Changwei Ren
AU - Yongqiang Lai
AU - Hao Cui
PY - 2026
DA - 2026/07/01
JO - Journal of cardiothoracic surgery
DO - 10.1186/s13019-026-04150-5
UR - https://europepmc.org/article/MED/42894230
AB - Background Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital cardiac anomaly characterized by atrioventricular and ventriculoarterial discordance, resulting in a physiologically corrected circulation. When ccTGA is combined with dextrocardia and situs inversus totalis, surgical management becomes particularly challenging because of the mirror-image anatomy and altered spatial orientation.Case presentation A 61-year-old man presented with progressive dyspnea and was diagnosed with ccTGA accompanied by dextrocardia and situs inversus totalis. Transthoracic echocardiography revealed severe regurgitation of the systemic atrioventricular valve (morphological tricuspid valve) with dilation and systolic dysfunction of the systemic right ventricle. Comprehensive preoperative imaging confirmed atrioventricular and ventriculoarterial discordance, right-sided cardiac apex, and complete visceral inversion. Tricuspid valve replacement was performed via a median sternotomy with the surgeon standing on the patient's left side to accommodate the mirror-image anatomy. Cardiopulmonary bypass was established safely after meticulous identification of the great vessels. A mechanical prosthetic valve was successfully implanted. The postoperative course was uneventful, and follow-up echocardiography at six months confirmed satisfactory prosthetic valve function without complications.Conclusions This case illustrates that tricuspid valve replacement can be safely and effectively performed in patients with ccTGA complicated by dextrocardia and situs inversus totalis. A left-sided surgical approach, combined with thorough preoperative imaging and careful intraoperative anatomical verification, may help restore operative orientation and reduce technical complexity in patients with mirror-image cardiac anatomy.
SN - 1749-8090
ER -