Morphometric characteristics of the aorta and heart in situs inversus totalis

Situs inversus totalis is a rare condition of visceral transposition in thoracic and abdominal cavities. Computed tomography (CT)-based morphometric analysis of the cardiovascular system prior to the surgery helps to describe vessel topography and size, choose the right surgical insertion site, avoid vessel trauma, and prevent hemorrhage during surgical intervention. We present a case report of situs inversus totalis detected incidentally in a 74-year-old male with the acute abdominal syndrome. Appropriate detailed aorta measurements are used to choose an adequate size of the aortic prosthesis during open surgical repair or endovascular aneurysm repair. An accurate assessment of the vessels on CT scans assists in consideration of the catheter diameter and the most reliable cannulation site. Vessel size correlates with morphological conditions (kinking, stenosis, occlusion), which may be considered a risk of organ malperfusion. The anatomical analysis prior to surgery in different anatomical variations may ensure patient safety and predict complications.