Coronary Artery Bypass Grafting in a Patient with Dextrocardia with Situs Inversus

• Main Authors: Kaitlin E. Woods, J. W. Awori Hayanga, Daniel Sloyer, Roy E. Henrickson, Lawrence M. Wei, Heather K. Hayanga
• Format: Article
• Language: English
• Published: Hindawi Limited 2020-01-01
• Series: Case Reports in Anesthesiology
• Online Access: http://dx.doi.org/10.1155/2020/8885881

Dextrocardia involves embryologic malformations leading to a right hemithorax heart with rightward apex. Situs inversus encompasses all viscera in mirrored position. A 76-year-old male with dextrocardia with situs inversus presented for coronary artery bypass grafting due to a non-ST elevation myocardial infarction. Management was altered accordingly. Electrocardiography leads and defibrillator pads were reversed. A left internal jugular vein central venous catheter provided direct access to the right atrium. Transesophageal echocardiography confirmation of aortic and venous cannulation required turning the probe right for the right-sided aorta and left for liver visualization, respectively. Proactive surgical and anesthetic management was imperative for the successful and uneventful outcome for this patient.