[Transcatheter Aortic Valve Implantation in a Patient With Dextrocardia and Situs Inversus Totalis].

Abstract

The patient is a man in his 60s with situs inversus totalis. He underwent percutaneous coronary intervention for an old myocardial infarction in his 40s and coronary artery bypass grafting( CABG) in his 60s. Through preoperative examination of CABG, moderate aortic stenosis( AS) was disclosed, and he was under outpatient follow-up. He was referred to our department because AS became severe. Since operative mortality and morbidity were high, we chose transcatheter aortic valve implantation (TAVI) as the treatment option. Fluoroscopic images were mirrored, and the delivery system was rotated 180 degrees at the time of insertion because he had situs inversus totalis. TAVI was successful, and he was discharged home without complications. In peculiar cases such as anatomical anomalies, it is crucial to perform TAVI safely. In the case of situ inversus totalis, mirroring fluoroscopic images and device inversion were beneficial.