We report a 67-year-old woman who was diagnosed at adulthood a rare and complex congenital heart disease: a corrected transposition of the great vessels and situs inversus.
Patient presented with progressive worsening right heart failure (NYHA class 2).
A cardiac MDCT scan was scheduled to plan surgical tricuspid replacement.
According to the segmental analysis using axial slices, MDCT showed situs inversus and atrio-ventricular discordance ( Fig. 1 ), associated with ventriculo-arterial discordance ( Fig. 2 ). In addition, unique coronary artery was disclosed using 3D images ( Fig. 3 ).
Axial slices from upper abomen to the thorax level. a: on the abdominal level: the liver is on the left side, corresponding to an abdominal situs inversus; b: on the thoracic level: the inferior venae cavae is connected to the right atrium, the latter being left-sided: atrial situs inversus; c: the right ventricle (with trabeculations) is on the right side of the thorax and the left ventricle on the left one (normal ventricular situs); d: the right atrium is connected to the left ventricle and the left atrium is connected to the right ventricle (atrioventricular discordance). Ao: Aorta; CA: coronary artery; IVC: inferior venae cavae; LA: left atrium; LV: left ventricle; PA: pulmonary artery; RA: right atrium; RV: right ventricle.
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