Left-sided 3D totally endoscopic mitral valve repair guided by left atrial appendage orientation in situs inversus totalis with mirror-image dextrocardia: a case report.
Qiuji Wang, Dagang Li, Gengliang Qin et al.
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Case in brief
A 39-year-old woman with situs inversus totalis and mirror-image dextrocardia presented with progressive exertional dyspnea due to severe mitral regurgitation from posterior leaflet prolapse. A left-sided three-dimensional totally endoscopic mitral valve repair was performed, utilizing the left atrial appendage for segment orientation. Postoperative echocardiography confirmed successful repair with no residual mitral regurgitation and preserved left ventricular function.
What made this case unusual
The case highlights the successful application of a totally endoscopic approach to mitral valve repair in a patient with complex anatomical challenges due to situs inversus totalis and mirror-image dextrocardia.
Diagnostic / clinical pearl
The left atrial appendage can serve as a reliable anatomical landmark for segment orientation during mitral valve repair in patients with mirror-image anatomy.
Why it matters
This case underscores the importance of tailored operative strategies in complex anatomical conditions, enhancing the feasibility of minimally invasive cardiac procedures.