Abstract
We experienced anesthetic management of a case of complete situs inversus (CSI). A seventy-seven year old man who had CSI in his past history underwent emergency coronary artery bypass grafting surgery (CABG) under general anesthesia. For intraoperative anesthetic management, transesophageal echocardiography (TEE) was carried out by exactly just the opposite. We scanned the typical 4 chamber view on position of 180° and typical long axis view is scanned on position of 55°. Moreover, to eliminate any discomfort by reversible view caused by CSI, intraoperative manipulation of TEE should be confirmed thorough the mirror that was attached to the other side of the TEE monitor.
We concluded that if the intraoperative scanning plane of TEE was performed on the CSI patient, 180° of scanning position must be considered as 0° to aim the basic findings. Moreover, to eliminate discomfort by reversible view caused by CSI, manipulation of TEE should be confirmed thorough the mirror that was attached to the other side of the TEE monitor. However, to avoid the oversight of other cardiac anomalies caused by congenital incomplete situs inversus, we must assess malformed abdominal abnormality if dextrocardia was detected in the patient's chest X-ray.
