Dextrocardia: technical aspects of reoperative aortic and tricuspid valve replacement.

Tricuspid and aortic valve replacement was performed on a 50-year old man with dextrocardia, situs solitus, D-ventricular looping, and normally related great arteries. Twenty-two years earlier the patient had undergone repair of an incomplete atrioventricu lar canal and mitral valve replacement. The anatomic issues and operative considerations are discussed for aortic and tricuspid valve replacement in this anatomic situation with special emphasis on tricuspid valve replacement through a right ventriculotomy. Six months after surgery, New York Heart Association functional class improved from class III preoperatively, to class II.