Thanh bên bài viết

PDF
Ngày xuất bản: 30/08/2025
Số lượt xem tóm tắt: 6
Số lượt xem PDF: 0
DOI: 10.47972/vjcts.v52i.1489
Số xuất bản
Tập 52
Chuyên mục
Bài báo
Trích dẫn bài báo
Nguyen, S. H., Ngo, T. H., Duong, X. P., & Pham, T. H. (2025). Totally endoscopic mitral valve repair in situs inversus totalis: how to do it. Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam, 52, 37 - 43. https://doi.org/10.47972/vjcts.v52i.1489

Totally endoscopic mitral valve repair in situs inversus totalis: how to do it

Nguyen Sinh Hien1, , Ngo Thanh Hung1, Duong Xuan Phuong2, Pham Thi Hue
1 Hanoi Heart Hospital
2 Phu Tho General Hospital

Nội dung chính của bài viết

Tóm tắt

Background: Situs inversus totalis (SIT) is a rare congenital condition characterized by complete mirror-image transposition of thoracic and abdominal organs. When combined with dextrocardia, it poses significant anatomical and ergonomic challenges for cardiac surgery, particularly for minimally invasive approaches.


Case Presentation: A 68-year-old female was admitted to our hospital with dyspnea on exertion. Chest X-ray and chest computerized tomography (CT) confirmed SIT without venous anomalies. Transthoracic echocardiography demonstrated severe mitral valve regurgitation caused by rupture of the chordae posterior leaflet. The patient underwent totally endoscopic mitral valve repair through a left mini-thoracotomy, with implantation of a size 28 Carpentier annuloplasty ring.


Discussion: Totally endoscopic surgery allows for enhanced visualization and a broader operative field when approaching the mitral valve through a left mini-thoracotomy. The success of the procedure largely depends on the experience and technical expertise of the surgical team. The challenges in surgery include reversed visual orientation and hand movements compared to normal.


Conclusion: Totally endoscopic mitral valve repair in SIT is feasible and safe procedure.

Từ khóa

Situs inversus totalis, Dextrocardia, Totally endoscopic, Mitral valve repair

Chi tiết bài viết

Tài liệu tham khảo

1. Blegen HM. Surgery In Situs Inversus. Annals of Surgery. 1949;129(2):244. https://doi: 10.1097/00000658-194902000-00009
2. Tripathi S, Ajit Kumar VK. Comparison of Morphologic Findings in Patients with Dextrocardia with Situs Solitus vs Situs Inversus: a Retrospective Study. Pediatr Cardiol. 2019;40(2):302-309. https://doi:10.1007/s00246-018-2007-4
3. Bohun CM, Potts JE, Casey BM, Sandor GGS. A Population-Based Study of Cardiac Malformations and Outcomes Associated With Dextrocardia. American Journal of Cardiology. 2007;100(2):305-309. https://doi:10.1016/j.amjcard.2007.02.095
4. Postema MC, Carrion-Castillo A, Fisher SE, Vingerhoets G, Francks C. The genetics of situs inversus without primary ciliary dyskinesia. Sci Rep. 2020;10(1):3677.
https://doi:10.1038/s41598-020-60589-z
5. Svensson LG, Atik FA, Cosgrove DM, et al. Minimally invasive versus conventional mitral valve surgery: A propensity-matched comparison. The Journal of Thoracic and Cardiovascular Surgery. 2010;139(4):926-932.e2. doi:10.1016/j.jtcvs.2009.09.038
6. Sündermann SH, Sromicki J, Rodriguez Cetina Biefer H, et al. Mitral valve surgery: Right lateral minithoracotomy or sternotomy? A systematic review and meta-analysis. The Journal of Thoracic and Cardiovascular Surgery. 2014;148(5):1989-1995.e4. https://doi:10.1016/j.jtcvs.2014.01.046
7. Goldstone AB, Atluri P, Szeto WY, et al. Minimally invasive approach provides at least equivalent results for surgical correction of mitral regurgitation: A propensity-matched comparison. The Journal of Thoracic and Cardiovascular Surgery. 2013;145(3):748-756. https://doi:10.1016/j.jtcvs.2012.09.093
8. Bohun CM, Potts JE, Casey BM, Sandor GGS. A Population-Based Study of Cardiac Malformations and Outcomes Associated With Dextrocardia. The American Journal of Cardiology. 2007;100(2):305-309.
https://doi:10.1016/j.amjcard.2007.02.095
9. Goldstone AB, Patrick WL, Bilbao MS, Woo YJ. Minimally invasive mitral valve repair in situs inversus totalis. Journal of Cardiac Surgery. 2016;31(12):718-720. doi:10.1111/jocs.12859
10. Pham CV, Nguyen DH, Vo AT, Nguyen TT, Phan LH, Nguyen BH. Minimally invasive mitral valve replacement and concomitant Cox-Maze IV procedure using radiofrequency energy in situs inversus totalis: A case report. International Journal of Surgery Case Reports. 2020;73:285-288. https://doi:10.1016/j.ijscr.2020.07.053
11. Maldjian PD, Saric M. Approach to dextrocardia in adults: review. AJR Am J Roentgenol. 2007;188(6 Suppl):S39-49; quiz S35-38. https://doi:10.2214/AJR.06.1179
12. Worku B, Robinson S, Gulkarov I, Acinapura A, Tortolani AJ. Mitral Valve Operation in Dextrocardia. Ann Thorac Surg. 2016;101(5):e161. https://doi:10.1016/j.athoracsur.2015.12.027
13. Kikon M, Kazmi A, Gupta A, Grover V. Left-sided approach for mitral valve replacement in a case of dextrocardia with situs solitus. Interactive CardioVascular and Thoracic Surgery. 2013;17(5):900-902. https://doi:10.1093/icvts/ivt314