What question did this study set out to answer?

To explore the implications of conducting transcatheter aortic valve implantation in patients with situs inversus totalis and associated cardiovascular issues.

April 1, 2026Open Access

A Case of Aortic Valve Implantation by Transcarotid Approach for Aortic Stenosis in Dextrocardia with Situs Inversus

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Severe aortic valve stenosis with situs inversus totalis (n=1). Intervention: Transcarotid transcatheter aortic valve implantation (TC-TAVI). Primary outcome: Procedural success and neurological complications.

YEYuki EchieFukuyama City Hospital HMHironobu MorimotoFukuyama City Hospital THTakashi HaradaFukuyama Cardiovascular Hospital

Key Result

Transcarotid transcatheter aortic valve implantation combined with horizontal fluoroscopic image inversion was safely and successfully performed in a patient with severe aortic stenosis and situs inversus.

Key Points

To explore the implications of conducting transcatheter aortic valve implantation in patients with situs inversus totalis and associated cardiovascular issues.
Case report of aortic valve implantation by transcarotid approach.
Examination of the anatomical challenges posed by situs inversus totalis.
Evaluation of procedural success and complications in the context of mirror-image anatomy.
Successful aortic valve implantation achieved through transcarotid approach.
Demonstrated technical feasibility despite anatomical challenges.
Highlighted the importance of individualized surgical planning for situs inversus patients.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

An 80-year-old male with severe symptomatic aortic valve stenosis, situs inversus totalis, and severe peripheral arterial disease making transfemoral access unsuitable.

Intervention

Transcarotid transcatheter aortic valve implantation (TC-TAVI) using a 23-mm SAPIEN 3 Ultra Resilia valve, combined with horizontal fluoroscopic image inversion.

Outcome

Procedural success and absence of procedural or neurological complications

Transcarotid TAVI combined with horizontal fluoroscopic image inversion is a safe and effective strategy for patients with severe aortic stenosis and mirror-image anatomy (situs inversus totalis) who are unsuitable for transfemoral access.

Limitations

Single case report
Potential risks of the transcarotid approach including stroke and carotid artery complications

Abstract

Objective: Situs inversus totalis is a rare congenital condition that may be associated with cardiovascular abnormalities. Transcatheter aortic valve implantation (TAVI) in such patients is technically challenging because of the mirror-image anatomy of the heart and great vessels.

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Cite This Study

Echie et al. (Thu,) conducted a case report in Severe aortic valve stenosis with situs inversus totalis (n=1). Transcarotid transcatheter aortic valve implantation (TC-TAVI) was evaluated on Procedural success and neurological complications. Transcarotid transcatheter aortic valve implantation combined with horizontal fluoroscopic image inversion was safely and successfully performed in a patient with severe aortic stenosis and situs inversus.

synapsesocial.com/papers/69cd7a095652765b073a6dc9 https://doi.org/https://doi.org/10.33290/jtvt.cr.26-0002