NEW DELHI: Doctors at RML Hospital and ABVIMS have successfully performed a complex cardiac procedure on a 31-year-old woman with Situs inversus totalis, a rare condition in which internal organs are arranged in a mirror-image position.
The patient from Gurgaon in Haryana also had a congenital heart defect—Partial atrioventricular canal defect—which required surgical correction.
According to Dr Narender Singh Jhajhria, Director Professor and Head of Cardiothoracic and Vascular Surgery, the coexistence of both conditions made the case technically demanding.
In most such cases globally, open-heart surgery is preferred, as it provides surgeons with direct access to the heart, particularly when anatomical orientation is altered. However, the team opted for a minimally invasive approach.
The surgery was carried out through a small incision of approximately 4 cm under the breast, without opening the chest bone. Doctors said this approach reduces surgical trauma and improves recovery outcomes, but is rarely attempted in patients with reversed anatomy due to increased complexity.
The procedure involved establishing cardiopulmonary bypass by connecting the patient to a heart-lung machine. This step required careful planning, as the positioning of major blood vessels was reversed. The surgical team then repaired the cardiac defect using a patch created from the patient’s pericardium.
Doctors noted that the mirror-image anatomy required continuous adjustment during the procedure, as standard surgical orientation does not apply. Precision was critical to avoid damage to heart valves and the conduction system.
The cardiac anaesthesia team, led by Dr Jasvinder Kaur Kohli, managed intraoperative stability, while the perfusion team under Jagdish Chandra operated the heart-lung machine.
Such minimally invasive correction in a patient with situs inversus is rarely reported, with most documented cases managed through conventional open surgery.
The patient had an uneventful recovery, and post-operative evaluation confirmed successful repair of the defect.
Dr Ashok Kumar, Director of ABVIMS and RML Hospital, acknowledged the coordinated effort of the surgical, anaesthesia and support teams.
The procedure was performed under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, officials said.
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