Three patients of mirror-image dextrocardia were subjected to balloon
valvuloplasty at our institute. One patient had severe pliable rheumat
ic mitral stenosis (MS), another had severe calcific rheumatic MS and
the third had moderate rheumatic MS and severe rheumatic aortic stenos
is (AS). Necessary modifications in the standard septal puncture techn
ique, Inoue mitral valvuloplasty technique, and Cribier aortic valvulo
plasty technique were done keeping unusual anatomy of mirror-image dex
trocardia in account to dilate mitral and aortic stenosis successfully
. Acute hemodynamic results were satisfactory and no complications enc
ountered. This report illustrates feasibility and safety of balloon mi
tral and aortic valvuloplasty in the complex cardiac anatomy of situs
inversus totalis.