VSD device closure in situs inversus with dextrocardia: technical challenges and solutions: a case report

Abstract Background Situs inversus with dextrocardia (SI-DC) is rarely associated with congenital heart defects. Traditionally, ventricular septal defect (VSD) in such patients has been managed surgically. Percutaneous VSD device closure in SI-DC, albeit a suitable alternative, has been seldom repor...

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Main Authors: Abhimanyu Uppal, Bhushan Shah, Rambabu Sharma, Ashok Garg
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:The Egyptian Heart Journal
Subjects:
Online Access:https://doi.org/10.1186/s43044-025-00665-9
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author Abhimanyu Uppal
Bhushan Shah
Rambabu Sharma
Ashok Garg
author_facet Abhimanyu Uppal
Bhushan Shah
Rambabu Sharma
Ashok Garg
author_sort Abhimanyu Uppal
collection DOAJ
description Abstract Background Situs inversus with dextrocardia (SI-DC) is rarely associated with congenital heart defects. Traditionally, ventricular septal defect (VSD) in such patients has been managed surgically. Percutaneous VSD device closure in SI-DC, albeit a suitable alternative, has been seldom reported. The present report describes the unique challenges of mirror-image cardiac anatomy and suggests technical modifications for successful percutaneous closure. Case summary A 4-year-old boy, previously diagnosed with SI-DC and a moderate-size perimembranous VSD, presented with a history of poor weight gain and dyspnea. A 2D echocardiogram indicated that the septal defect was suitable for device closure. The procedure was adapted to account for the altered cardiac anatomy by adjusting the fluoroscopic angles and wire-torquing maneuvers. A Konar-multifunction occluder device MFO® 7-5mm was successfully deployed via retrograde approach without complications utilizing hemodynamic and echocardiographic guidance. No excess contrast volume or fluoroscopic radiation dose was used during the procedure due to meticulous pre-procedure planning. Conclusion VSD device closure in atypical scenarios like SI-DC is both safe and feasible with thorough pre-procedure planning tailored to the "mirror image" cardiac anatomy.
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series The Egyptian Heart Journal
spelling doaj-art-321b63bb0d544b878fe3a1565f36b3ec2025-08-20T04:01:36ZengSpringerOpenThe Egyptian Heart Journal2090-911X2025-07-017711710.1186/s43044-025-00665-9VSD device closure in situs inversus with dextrocardia: technical challenges and solutions: a case reportAbhimanyu Uppal0Bhushan Shah1Rambabu Sharma2Ashok Garg3Priyanka Hospital and cardiac centerAIIMS BhopalJK Lon hospitalMD General Medicine, Priyanka Hospital and cardiac centerAbstract Background Situs inversus with dextrocardia (SI-DC) is rarely associated with congenital heart defects. Traditionally, ventricular septal defect (VSD) in such patients has been managed surgically. Percutaneous VSD device closure in SI-DC, albeit a suitable alternative, has been seldom reported. The present report describes the unique challenges of mirror-image cardiac anatomy and suggests technical modifications for successful percutaneous closure. Case summary A 4-year-old boy, previously diagnosed with SI-DC and a moderate-size perimembranous VSD, presented with a history of poor weight gain and dyspnea. A 2D echocardiogram indicated that the septal defect was suitable for device closure. The procedure was adapted to account for the altered cardiac anatomy by adjusting the fluoroscopic angles and wire-torquing maneuvers. A Konar-multifunction occluder device MFO® 7-5mm was successfully deployed via retrograde approach without complications utilizing hemodynamic and echocardiographic guidance. No excess contrast volume or fluoroscopic radiation dose was used during the procedure due to meticulous pre-procedure planning. Conclusion VSD device closure in atypical scenarios like SI-DC is both safe and feasible with thorough pre-procedure planning tailored to the "mirror image" cardiac anatomy.https://doi.org/10.1186/s43044-025-00665-9Situs inversus with dextrocardiaMirror-image dextrocardiaVentricular septal defectDevice closureRetrograde VSD closureCase report
spellingShingle Abhimanyu Uppal
Bhushan Shah
Rambabu Sharma
Ashok Garg
VSD device closure in situs inversus with dextrocardia: technical challenges and solutions: a case report
The Egyptian Heart Journal
Situs inversus with dextrocardia
Mirror-image dextrocardia
Ventricular septal defect
Device closure
Retrograde VSD closure
Case report
title VSD device closure in situs inversus with dextrocardia: technical challenges and solutions: a case report
title_full VSD device closure in situs inversus with dextrocardia: technical challenges and solutions: a case report
title_fullStr VSD device closure in situs inversus with dextrocardia: technical challenges and solutions: a case report
title_full_unstemmed VSD device closure in situs inversus with dextrocardia: technical challenges and solutions: a case report
title_short VSD device closure in situs inversus with dextrocardia: technical challenges and solutions: a case report
title_sort vsd device closure in situs inversus with dextrocardia technical challenges and solutions a case report
topic Situs inversus with dextrocardia
Mirror-image dextrocardia
Ventricular septal defect
Device closure
Retrograde VSD closure
Case report
url https://doi.org/10.1186/s43044-025-00665-9
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AT rambabusharma vsddeviceclosureinsitusinversuswithdextrocardiatechnicalchallengesandsolutionsacasereport
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