SURGICAL CLOSURE OF ATRIAL SEPTAL DEFECT IN DEXTROCARDIA WITH SITUS INVERSUS USING BICAVAL CANNULATION A SURGICAL CHALLENGE

Abstract

Dextrocardia is a rarely seen cardiac
malposition, often associated with multiple
and complex congenital cardiac
anomalies. In this era of device closure
of septal defects, atrial septal defects requiring
surgical closure in dextrocardia
with situs inversus is rare. Surgeons require
a prospective strategy for handling
problems such as adequacy of exposure
for appropriate cannulation and difficulty
in comprehending the intra cardiac anatomy
due to the mirror imaging. Here we
present a case of atrial septal defect with
dextrocardia and situs inversus who had
undergone the surgical closure of the
same under bicaval cannulation. Femoral
venous cannulation recommended by
some authors is best avoided due to the
possible variation in major venous anatomy.
We also recommend that the operating
surgeon stands on the left side of
the patient to improve exposure.
Keyword :Cardiopulmonary bypass,
Dextrocardia, Situs inversus, Atrial
septal defect