{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T15:36:11Z","timestamp":1766158571154},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T00:00:00Z","timestamp":1601337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T00:00:00Z","timestamp":1601337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Discordant atrioventricular connection with concordant ventriculoarterial connection, otherwise known as isolated ventricular inversion (IVI), is an extremely rare congenital cardiac malformation. Reports on the corrective surgery for this anomaly in neonates are few, and the procedure is difficult and complicated. Herein, we report our use of atrial septostomy as a palliative procedure followed by corrective surgery for the repair of neonatal IVI with situs ambiguous(inversus) morphology.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 2-day-old girl weighing 3.5\u00a0kg was admitted to our hospital with a low oxygen saturation (SpO<jats:sub>2<\/jats:sub>) of 70% She was diagnosed with IVI [situs ambiguous(inversus), D-loop, and D-Spiral], atrial septal defect, patent ductus arteriosus (PDA), interrupted inferior vena cava with azygos continuation to the left superior vena cava (SVC), and polysplenia by transthoracic echocardiography and cardiac computed tomography. We planned to perform corrective surgery and decided to first increase interatrial mixing by performing surgical atrial septostomy and PDA ligation 7\u00a0days after birth. However, despite the surgical septostomy, pulmonary venous blood flowed toward the right ventricle via the tricuspid valve rather than toward the left-sided atrium and hypoxemia persisted. We decided to perform the intra-atrial switch procedure at the age of 17\u00a0days via a re-median sternotomy. The cardiopulmonary bypass (CPB) circuit was established with ascending aorta and venous drainage through the SVC and hepatic veins. Utilizing a left-sided atrium(l-A) approach, a bovine pericardial patch was used for the intra-atrial baffle, which was trimmed into a trouser-shaped patch. Continuous suture using the patch was lying from the front of the right-sided upper pulmonary vein and rerouted SVC, hepatic vein, and coronary sinus to the tricuspid valve. Overall, CPB weaning proceeded smoothly; however, direct current cardioversion was performed for junctional ectopic tachycardia. The postoperative course was uneventful. Her postoperative SpO<jats:sub>2<\/jats:sub> improved (approximately 99\u2013100%); overall, the patient showed clinical improvement. Discharge echocardiography showed normal biventricular function and an intact atrial baffle with no venoatrial or atrioventricular obstruction.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>We successfully performed an intra-atrial switch procedure for isolated ventricular inversion in a neonate. Long-term follow-up will be necessary to ensure the maintenance of optimal cardiac function.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40792-020-01016-3","type":"journal-article","created":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T14:04:22Z","timestamp":1601388262000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Neonatal intra-atrial baffle repair for isolated ventricular inversion with left isomerism: a case report"],"prefix":"10.1186","volume":"6","author":[{"given":"Yuta","family":"Kuwahara","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukihiro","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuya","family":"Komori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naohiro","family":"Kabuto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Wada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,9,29]]},"reference":[{"key":"1016_CR1","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/0167-5273(91)90280-3","volume":"31","author":"MS Ranjit","year":"1991","unstructured":"Ranjit MS, Wilkinson JL, Mee RBB. Discordant atrioventricular connexion with concordant ventriculo-arterial connection(so-called isolated ventricular inversion) with usual atrial arrangement(situs solitus). Inter J Cardiol. 1991a;31:114\u20137.","journal-title":"Inter J Cardiol"},{"key":"1016_CR2","doi-asserted-by":"publisher","first-page":"E21","DOI":"10.5152\/akd.2015.6432","volume":"15","author":"S Murat","year":"2015","unstructured":"Murat S, Aysel T, Ersin E. A rare indication for senning operation: isolated ventricular inversion and ventricular septal defect. Anatol J Cardiol. 2015;15:E21.","journal-title":"Anatol J Cardiol"},{"key":"1016_CR3","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1016\/0003-4975(96)00546-2","volume":"62","author":"BM Doff","year":"1996","unstructured":"Doff BM, Mohan R, Norman H, et al. Intraatrial baffle repair of isolated ventricular inversion with left atrial isomerism. Ann Thorac Surg. 1996;62:1529\u201332.","journal-title":"Ann Thorac Surg"},{"key":"1016_CR4","unstructured":"Stark J. Concordant transposition-Mustard operation. Surgery for congenital heart defects, 1st edition. Grune and Stratton, 1983."},{"key":"1016_CR5","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/0002-9149(66)90222-0","volume":"17","author":"R Van Praagh","year":"1966","unstructured":"Van Praagh R, Van Praagh S. Isolated ventricular inversion: a consideration of the morphogenesis, definition and diagnosis of nontransposed and transposed great arteries. Am J Cardiol. 1966;17:395\u2013406.","journal-title":"Am J Cardiol"},{"key":"1016_CR6","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1136\/hrt.53.4.443","volume":"53","author":"P Arciprete","year":"1985","unstructured":"Arciprete P, Macatney FJ, de Leval M, et al. Mustard\u2019s operation for patients with ventriculoarterial concordance: report of two cases and a cautionary tale. 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Int J Cardiol. 1991b;31:114\u20137.","journal-title":"Int J Cardiol"},{"key":"1016_CR9","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/0002-8703(81)90207-6","volume":"101","author":"L Mauri","year":"1981","unstructured":"Mauri L, Christopher L, Elliott S, et al. A rare congenital cardiac malformation with situs inversus and discordant atrioventricular and concordant ventriculoarterial connections: dignosis and surgical treatment. Am Heart J. 1981;101:355\u20136.","journal-title":"Am Heart J"},{"key":"1016_CR10","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1016\/0003-4975(95)00538-V","volume":"60","author":"H Uemura","year":"1995","unstructured":"Uemura H, Ho SY, DeVine WA, Kilpatrick LL, Anderson RH. Atrial appendages and venoatrial connectionsin hearts from patients with visceral heterotaxy. 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