A 22-year-old Iraqi female was brought to Metro Hospital, Faridabad recently with complaints of severe breathlessness on minimal exertion. She is a known case of severe aortic regurgitation with suspected vegetation indicative of infective endocarditis on the damaged aortic valve and dextrocardia with situs inversus.
Aortic regurgitation is a condition of heart valve where due to structural deformity, the valve starts leaking & not able to maintain unidirectional flow of blood from left ventricle to aorta & this backflow of blood during diastole (relaxation). Vegetations are mass of bacteria, platelets fibrin & inflammatory cells & is an indicator of infection of valve surface, causing progressive damage. In addition to this, she was also a case of dextrocardia with situs inversus which is a congenital condition where all organs of the body are placed on the opposite side of the body like the heart which normally is on the left side of the body, is on the right side.
In this patient, after evaluation and detailed Echo, the patient was taken up for Aortic valve replacement with valve replacement with tissue valve (bioprosthetic valve). During operation, we found that there was a membranous growth below the aortic valve which gave the appearance of a vegetation on pre-op evaluation this was also removed and sent for histopathological examination. Post-operatively patient remained good and recovered very nicely.
Dr. Saurabh Juneja said, “dextrocardia with situs inversus is a very rare condition which occurs in 1:16000 population. It was a challenging case as the heart chambers are in a totally opposite direction in comparison to patient undergoing routine bypass surgery”.
It was technically a difficult case due to dextrocardia with situs inversus but CTVS team headed by Dr. Saurabh Juneja did a wonderful job. Said Dr. Bansal, MD & Sr. Interventional cardiologist.