SURGICAL CLOSURE OF ATRIAL SEPTAL DEFECT IN DEXTROCARDIA WITH SITUS INVERSUS USING BICAVAL CANNULATION A SURGICAL CHALLENGE

Dextrocardia is a rarely seen cardiac malposition, often associated with multiple and complex congenital cardiac anomalies. In this era of device closure of septal defects, atrial septal defects requiring surgical closure in dextrocardia with situs inversus is rare. Surgeons require a prospective strategy for handling problems such as adequacy of exposure for appropriate cannulation and difficulty in comprehending the intra cardiac anatomy due to the mirror imaging. Here we present a case of atrial septal defect with dextrocardia and situs inversus who had undergone the surgical closure of the same under bicaval cannulation. Femoral venous cannulation recommended by some authors is best avoided due to the possible variation in major venous anatomy. We also recommend that the operating surgeon stands on the left side of the patient to improve exposure.