{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:48:09Z","timestamp":1770814089374,"version":"3.50.1"},"reference-count":9,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"unspecified","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,1,4]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>Situs inversus totalis (SIT) with congenitally corrected transposition of the great arteries (ccTGA) represents a rare and complex congenital combination that significantly complicates anaesthetic management. We report the anaesthetic management of an early childhood (2\u20135 years), 13\u2009kg child diagnosed with SIT and ccTGA undergoing elective adenotonsillectomy. Individualised perioperative strategies were implemented, including modified ECG monitoring, arrhythmia preparedness and explicit mg\/kg drug dosing. Intraoperative management was uneventful, and the patient had a stable recovery. This case highlights anaesthetic considerations and monitoring adaptations in non-cardiac paediatric surgery involving mirror-image congenital cardiac anatomy.<\/jats:p>","DOI":"10.1136\/bcr-2025-267307","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T15:23:24Z","timestamp":1770737004000},"page":"e267307","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Anaesthetic management of a paediatric patient with situs inversus totalis and congenitally corrected transposition of the great arteries undergoing adenotonsillectomy"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2540-7717","authenticated-orcid":false,"given":"Emine","family":"Ozcan","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Basaksehir Cam and Sakura City Hospital, Ba\u015fak\u015fehir, \u0130stanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"2026021023551084000_19.2.e267307.1","doi-asserted-by":"publisher","DOI":"10.1086\/339079"},{"key":"2026021023551084000_19.2.e267307.2","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.21037\/jtd.2019.10.15","article-title":"Congenitally corrected transposition of the great arteries","volume":"12","author":"Kumar","year":"2020","journal-title":"J Thorac Dis"},{"key":"2026021023551084000_19.2.e267307.3","doi-asserted-by":"crossref","first-page":"259","DOI":"10.5115\/acb.21.252","article-title":"Morphometric characteristics of the aorta and heart in situs inversus totalis","volume":"55","author":"Pidvalna","year":"2022","journal-title":"Anat Cell Biol"},{"key":"2026021023551084000_19.2.e267307.4","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.bjae.2024.08.004","article-title":"Anaesthesia for children with congenital heart disease undergoing non-cardiac surgery","volume":"24","author":"Spiro","year":"2024","journal-title":"BJA Educ"},{"key":"2026021023551084000_19.2.e267307.5","doi-asserted-by":"crossref","DOI":"10.1161\/HCQ.0000000000000113","article-title":"Perioperative Considerations for Pediatric Patients With Congenital Heart Disease Presenting for Noncardiac Procedures: A Scientific Statement From the American Heart Association","volume":"16","author":"Nasr","year":"2023","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2026021023551084000_19.2.e267307.6","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1053\/j.jvca.2019.06.015","article-title":"Anesthesia in Pediatric Patients With Congenital Heart Disease Undergoing Noncardiac Surgery: Defining the Risk","volume":"34","author":"Brown","year":"2020","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2026021023551084000_19.2.e267307.7","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.wjorl.2021.03.003","article-title":"Update on the safety of anesthesia in young children presenting for adenotonsillectomy","volume":"7","author":"McGuire","year":"2021","journal-title":"World J Otorhinolaryngol Head Neck Surg"},{"key":"2026021023551084000_19.2.e267307.8","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001285"},{"key":"2026021023551084000_19.2.e267307.9","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1053\/j.jvca.2023.03.034","article-title":"Perioperative Risk Assessment in Children With Congenital Heart Disease Undergoing Noncardiac Procedures","volume":"37","author":"Baijal","year":"2023","journal-title":"J Cardiothorac Vasc Anesth"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-267307","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T07:55:17Z","timestamp":1770796517000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-267307"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,10]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bcr-2025-267307"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-267307","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}