Off-pump coronary artery bypass surgery in a patient with dextrocardia and situs inversus: Anesthetic, surgical consideration and role of transesophageal echocardiography

Coronary artery bypass surgery (CABG) in dextrocardia with situs inversus patients is reported less in literature. Due to abnormal looping and associated other congenital anomalies, anesthetic implications and surgical difficulties become challenging in these patients. Transesophageal echocardiography examination (TEE) needs multiplane angle adjustments compared to normal heart to obtain the images. Here, we describe a 53-year-old female patient having dextrocardia with situs inversus who underwent CABG and discuss the perioperative management and multiplane adjustments during TEE examination.