{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T21:53:50Z","timestamp":1740174830888,"version":"3.37.3"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T00:00:00Z","timestamp":1724976000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T00:00:00Z","timestamp":1724976000000},"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"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Heart transplantation in patients with situs inversus is challenging, especially in terms of reconstruction of the systemic venous return. Several rerouting techniques have been presented but are associated with vulnerability to external compression, which might cause hemodynamic instability, especially in the presence of chest deformity. In this study, we report a rare case of successful heart transplantation in the presence of situs inversus and pectus excavatum.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 55-year-old man, with a history of surgeries for corrected transposition of the great arteries with ventricular septal defect, was registered for heart transplantation owing to progression of heart failure. Subsequently, he had undergone a left ventricular assist device implantation; 14\u00a0years after registration, he underwent transplantation of the heart with normal anatomy. The inferior vena cava was reconstructed by anastomosing the left atria with a counterclockwise rotation of the donor heart and by lengthening the recipient inferior vena cava with a conduit made of the residual right atrial tissue. The superior vena cava was reconstructed using a donor innominate vein harvested with sufficient length. After successful weaning from cardiopulmonary bypass, the chest could not be closed because the heart was compressed owing to chest deformity, resulting in hemodynamic instability. Therefore, to exclude the left lung, a left pericardial screen was created using a bovine pericardium, allowing the chest to be closed with acceptable hemodynamics. The patient suffered postoperatively from a higher venous pressure, suggesting an obstruction of venous return early after surgery. The obstruction gradually resolved, and the patient was transferred for rehabilitation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Heart transplantation in the presence of situs inversus is challenging; moreover, the presence of pectus excavatum further complicates the procedure. The paradoxically larger left lung and chest deformity compressed and impaired reconstructed systemic venous return. Although intrathoracic exclusion of the left lung was effective, an intraoperative or early postoperative thoracoplasty for pectus excavatum was also a viable option. Patient-specific management is mandatory, depending on the anatomy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-024-02006-5","type":"journal-article","created":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T03:44:04Z","timestamp":1724989444000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Orthotopic heart transplantation in patient with situs inversus and pectus excavatum: a case report"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3587-1629","authenticated-orcid":false,"given":"Satoru","family":"Wakasa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomonori","family":"Ooka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuma","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushige","family":"Shingu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuyasu","family":"Kato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiyuki","family":"Nagai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihisa","family":"Anzai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minoru","family":"Ono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiro","family":"Matsui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,30]]},"reference":[{"key":"2006_CR1","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1016\/S0022-5223(19)36980-6","volume":"99","author":"DB Doty","year":"1990","unstructured":"Doty DB, Renlund DG, Caputo GR, Burton NA, Jones KW. Cardiac transplantation in situs inversus. J Thorac Cardiovasc Surg. 1990;99:493\u20139.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2006_CR2","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1016\/j.jtcvs.2018.11.022","volume":"157","author":"SQ Duong","year":"2019","unstructured":"Duong SQ, Godown J, Soslow JH, Thurm C, Hall M, Sainathan S, et al. Increased mortality, morbidities, and costs after heart transplantation in heterotaxy syndrome and other complex situs arrangements. J Thorac Cardiovasc Surg. 2019;157:730\u201340.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2006_CR3","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/S0022-5223(98)70258-2","volume":"116","author":"LA Vricella","year":"1998","unstructured":"Vricella LA, Razzouk AJ, Gundry SR, Larsen RL, Kuhn MA, Bailey LL. Heart transplantation in infants and children with situs inversus. J Thorac Cardiovasc Surg. 1998;116:82\u20139.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2006_CR4","doi-asserted-by":"publisher","first-page":"e11","DOI":"10.1016\/j.athoracsur.2020.04.111","volume":"111","author":"D Jaroszewski","year":"2021","unstructured":"Jaroszewski D, Eldeib A, Gotimukul A, Lackey J, Gaitan B, DeValeria P, et al. Cardiac transplantation and consecutive minimally invasive pectus excavatum repair. Ann Thorac Surg. 2021;111:e11\u20134.","journal-title":"Ann Thorac Surg"},{"key":"2006_CR5","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1053\/j.sempedsurg.2018.05.006","volume":"27","author":"JA Sujka","year":"2018","unstructured":"Sujka JA, St Peter SD. Quantification of pectus excavatum: anatomic indices. Semin Pediatr Surg. 2018;27:122\u20136.","journal-title":"Semin Pediatr Surg"},{"key":"2006_CR6","first-page":"281","volume":"20","author":"DK Cooper","year":"1993","unstructured":"Cooper DK, Ye Y, Chaffin JS, Zuhdi N. A suggested technique for \u201corthotopic\u201d heart transplantation in a patient with situs inversus. Tex Heart Inst J. 1993;20:281\u20134.","journal-title":"Tex Heart Inst J"},{"key":"2006_CR7","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1016\/S0022-5223(19)36979-X","volume":"99","author":"JE Mayer Jr","year":"1990","unstructured":"Mayer JE Jr, Perry S, O\u2019Brien P, Perez-Atayde A, Jonas RA, Castaneda AR, et al. Orthotopic heart transplantation for complex congenital heart disease. J Thorac Cardiovasc Surg. 1990;99:484\u201391.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2006_CR8","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1111\/j.1540-8191.2007.00356.x","volume":"22","author":"D Ramzy","year":"2007","unstructured":"Ramzy D, Rao V, Delgado DH, Ross HJ, Cusimano RJ. Orthotopic cardiac transplantation in a patient with pectus excavatum: approach via left anterior thoracotomy. J Card Surg. 2007;22:145\u20137.","journal-title":"J Card Surg"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-024-02006-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-024-02006-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-024-02006-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T03:48:22Z","timestamp":1724989702000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-024-02006-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,30]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2006"],"URL":"https:\/\/doi.org\/10.1186\/s40792-024-02006-5","relation":{},"ISSN":["2198-7793"],"issn-type":[{"type":"electronic","value":"2198-7793"}],"subject":[],"published":{"date-parts":[[2024,8,30]]},"assertion":[{"value":"14 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This case report adheres to the ethical principles, and written informed consent was obtained from the patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent was obtained from the participant of this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"202"}}