Anesth Pain Med.  2019 Apr;14(2):193-196. 10.17085/apm.2019.14.2.193.

Anesthetic considerations for a patient with situs inversus totalis undergoing cardiac surgery: A case report

• Koo CH
• Shim JK
• Kim N
• Ki Y
• Park J
• Kim JC

• KMID: 2447968
• DOI: http://doi.org/10.17085/apm.2019.14.2.193

Abstract

A 58-year-old male patient with situs inversus totalis, a rare congenital malformation characterized by all asymmetric organs being formed as the mirror images of their normal morphologies, underwent mitral valve repair due to mitral valve prolapse. This case was reported to suggest that anesthesiologists should thoroughly understand the anatomy of these types of patients before providing cardiac anesthesia that often requires advanced monitoring and rely on their accurate interpretation. Accordingly, a few key points will be discussed with emphasis on reversing lead placement during electrocardiogram monitoring, using the left internal jugular vein for pulmonary artery catheterization, and firmly comprehending mirror image heart morphology to better conduct transesophageal echocardiography.

Keyword

Anesthesia; Situs inversus totalis; Thoracic surgery

MeSH Terms

Anesthesia
Catheterization, Swan-Ganz
Echocardiography, Transesophageal
Electrocardiography
Heart
Humans
Jugular Veins
Male
Middle Aged
Mitral Valve
Mitral Valve Prolapse
Situs Inversus*
Thoracic Surgery*