Emergent off-pump complete myocardial revascularization can be successfully performed in critically ill patients with acute myocardial infarction and mirror-image anatomy (dextrocardia with situs inversus totalis).
Dextrocardia is a rare condition not spared by coronary artery disease. We report the case of a 72-year-old patient with dextrocardia associated with situs inversus totalis who presented to our institution with acute myocardial infarction complicated by congestive heart failure. Due to the severe general conditions of the patient, an emergent off-pump complete myocardial revascularization was undertaken. The patient tolerated the procedure well and was asymptomatic at discharge. The technical aspects encountered in the setting of mirror-image anatomy and the advantages of off-pump myocardial revascularization in the critically ill patient are discussed.
Bonanomi et al. (Thu,) studied this question.