Double Valve Replacement In A Patient With Situs Inversus An
Dextrocardia is a rare congenital anomaly in which the base-apex axis of the heart is directed towards the right, and caudally. This cardiac malposition can occur with situs solitus, situs inversus or situs ambiguous (1). The importance of diagnosing a situs anomaly in an adult is to prevent errors in surgical operations, emergency procedures or interventional operations. This anatomic malposition affects all technical aspects of cardiac surgery, from the establishment of cardiopulmonary bypass (CPB) to exposure of the valves. Surgeons require a prospective strategy for handling problems such as poor exposure of the cannulation site and diseased valve. The case is described of a patient with dextrocardia with situs inversus, illustrating the anatomic issues and operative considerations peculiar to aortic and mitral valve surgery in patients with this condition.

Case Report
A 66-year-old male patient presented to our clinic with complaints of palpitation and dyspnea. His anamnesis was unremarkable and there was no surgical history. Atrial fibrillation with a ventricular rate of 88 beats per minute and counter clockwise rotation was detected by electrocardiography (ECG). Chest X-ray showed dextrocardia, and echocardiography revealed significant aortic valve stenosis and mitral valve insufficiency. Aortic and mitral valve surgery was recommended based on the current echocardiography and clinical findings. The ascending and arcus aorta and coronary arteries were found to be mirror image and also normal in the coronary angiography performed prior to surgery (Figure 1A and 1B). Abdominal tomography revealed an abdominal situs inversus (the liver on the left side of the abdomen, the spleen on the right and the inferior vena cava on the left of the aorta). Continuity of the inferior vena cava without any interruption and drainage into the right atrium located on the left side were noted....