Complete arterial revascularization in coronary artery bypass grafting in a patient with solitus inversus totalis.

Dextrocardia with complete situs inversus is a rare condition that occurs approximately in 2/10,000 live births. Coronary revascularization management in this setting differs in the technical considerations imposed by the malposition of the heart itself. We report here a case of complete arterial revascularization using both internal thoracic arteries and the left (homologous vessel to the right) gastroepiploic artery in an adult patient with triple-vessel disease and situs inversus totalis. Strategies for the choice of conduits and anastomoses as well as technical details are discussed.