How do we treat severely prolapsed true ectopia cordis?

Abstract Ectopia cordis is an extremely rare condition where the heart displaces outside the thoracic cavity. Treating this, especially when accompanied by congenital heart diseases and severe protrusion, is challenging. Here, we present a case of successful treatment involving intracardiac repair and delayed sternal closure using local skin flaps. A 35-year-old pregnant woman expecting monochorionic diamniotic twins underwent prenatal ultrasound for suspected foetal thoracic wall defects, ectopia cordis (EC) and potential congenital heart diseases (CHD).