Left-sided 3D totally endoscopic mitral valve repair guided by left atrial appendage orientation in situs inversus totalis with mirror-image dextrocardia: a case report - Report - MDSpire
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Three-Dimensional Totally Endoscopic Mitral Valve Repair Utilizing Left Atrial Appendage Orientation in a Case of Situs Inversus Totalis with Mirror-Image Dextrocardia

  • By

  • Qiuji Wang

  • Dagang Li

  • Gengliang Qin

  • Yalin Liao

  • Ping Zhao

  • Xu Chen

  • Ruiguo Qiao

  • Biru Zeng

  • Yueer Chen

  • Gangbing Ding

  • Xiaohua Liu

  • Hanwei Li

  • Bobo Shi

  • Xiaoxuan Lin

  • Daiqiang Huang

  • Zhaoxu Gai

  • Miao Xu

  • Qijun Zheng

  • Chunying Meng

  • September 25, 2026

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Clinical Report: Three-Dimensional Totally Endoscopic Mitral Valve Repair

Background

Situs inversus totalis (SIT) accompanied by mirror-image dextrocardia (MID) presents unique challenges during cardiac surgery due to the complete reversal of thoracoabdominal anatomy. Understanding these anatomical variations is crucial for surgical interventions, particularly in minimally invasive mitral valve procedures. Precise imaging and planning are emphasized to ensure safe surgical outcomes.

Data Highlights

The article did not provide numerical data or trial results, which may limit the generalizability of the findings.

Key Findings

  • The patient was a 39-year-old woman with severe mitral regurgitation due to P2 prolapse.
  • Preoperative transesophageal echocardiography provided critical anatomical evaluation for surgical planning.
  • Three-dimensional imaging facilitated the identification of mitral valve segments in a mirror-image operative field.
  • A multidisciplinary team approach was employed to review the operative plan, considering the patient's unique anatomical challenges.
  • The surgical technique involved a left-sided three-dimensional totally endoscopic approach tailored to the patient's reversed cardiac orientation.

Clinical Implications

This case highlights the importance of thorough preoperative imaging and planning in patients with complex anatomical variations.

Related Resources & Content

  1. Frontiers in Cardiovascular Medicine, 2026 -- Implantation of cardiac resynchronization therapy defibrillator with left bundle branch pacing in a patient with mirror-image dextrocardia: a case report
  2. Clinical Research in Cardiology, 2022 -- Concurrent transcatheter valve-in-valve procedures for severely compromised bioprosthetic aortic and mitral valves
  3. Int. Journal of Computer Assisted Radiology and Surgery, 2026 -- Development and feasibility testing of a dynamic image-derived simulation framework for assessing left atrioventricular valve repair strategies
  4. Surgical Endoscopy, 2024 -- Endoscopic Closure of Atrial Septal Defects in Functioning Beating Hearts
  5. New 2025 ESC/EACTS Guidelines for the management of valvular heart disease published - EACTS
  6. Transcatheter Edge-to-Edge Repair in a Patient With Severe Degenerative Mitral Regurgitation and Mirror-Image Dextrocardia | JACC: Case Reports
  7. New 2025 ESC/EACTS Guidelines for the management of valvular heart disease published - EACTS
  8. https://www.annalscts.com/article/view/17365/18214
  9. Transcatheter Edge-to-Edge Repair in a Patient With Severe Degenerative Mitral Regurgitation and Mirror-Image Dextrocardia | JACC: Case Reports

Original Source(s)

Left-sided 3D totally endoscopic mitral valve repair guided by left atrial appendage orientation in situs inversus totalis with mirror-image dextrocardia: a case report

  • by Qiuji Wang, Dagang Li, Gengliang Qin, Yalin Liao, Ping Zhao, Xu Chen, Ruiguo Qiao, Biru Zeng, Yueer Chen, Gangbing Ding, Xiaohua Liu, Hanwei Li, Bobo Shi, Xiaoxuan Lin, Daiqiang Huang, Zhaoxu Gai, Miao Xu, Qijun Zheng, Chunying Meng

  • September 25, 2026

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