Myocardial revascularization in dextrocardia with situs inversus totalis

Dextrocardia with situs inversus totalis occurs with an incidence of 1 in 10,000 and the pattern of susceptibility to coronary disease is similar to the general population. An adult male patient with situs inversus-dextrocardia who underwent percutaneous intervention for a discrete lesion in the right coronary artery presented two years later with rapid progression of lesions in the left coronary system. Off pump endarterectomy of the obtuse marginal branch and revascularization of the left anterior descending and obtuse marginal branch in this patient are discussed. In addition an outline of the natural history of normal appearing or mildly diseased coronary artery segments at follow-up angiography is presented.