RML Hospital Doctors Perform Rare Life Saving Surgery On Mirror Image Heart Patient

Even when the human body refuses to follow the usual map, doctors find a way—through skill, patience, and quiet determination.

This became evident in the case of thirty-one-year-old Reeta (name changed) from Gurgaon, who arrived at Dr. RML Hospital and ABVIMS with a condition so rare that most doctors may never encounter it in their careers: situs inversus totalis.

Inside her body, everything was reversed.

Her heart beat on the right side of her chest instead of the left. Her liver lay on the left, while her stomach and spleen were on the right. It was as if her internal world had been reflected in a mirror.

But there was more. She had been living with a congenital heart defect—partial atrioventricular canal defect—a condition present since birth, quietly affecting the structure of her heart, said Dr. Narender Singh Jhajhria, Director Professor and Head of Cardiothoracic and Vascular Surgery.

He explained that, individually, both conditions are complex. Together, they made her case exceptionally challenging.

Across the world, such cases are usually treated with open-heart surgery. Surgeons cut open the chest bone to gain full access, especially when anatomy is reversed. It is considered safer and more predictable.

Yet, in a remarkable feat, the doctors at RML Hospital, led by Dr. Jhajhria, chose not the easier path, but the better one for the patient.

The surgeons performed the entire operation through a small incision—barely 4 cm—under the breast. The chest bone remained untouched.

It was a minimally invasive, cosmetically gentle approach—rarely attempted in such complicated cases.

"The challenges began even before the first incision. To operate on the heart, we had to connect Reeta to a heart-lung machine—rerouting blood flow so the heart could be safely repaired. But with organs in reverse positions, even placing these connections required careful planning and precision," Dr. Jhajhria told The Health Outlook.

Inside the chest, the task became even more delicate. The surgeons repaired the defect using a patch made from the patient’s own pericardium—the thin covering of the heart. Each stitch had to be placed with exactness, protecting the heart valves and the electrical pathways that control the heartbeat.

The greatest challenge, however, was orientation, as everything was flipped.

Surgeons had to mentally rewire their instincts—working as if navigating a mirror image. Movements that usually come naturally had to be consciously reversed. It demanded not just expertise, but intense concentration at every step.

Behind the scenes, a coordinated team ensured the surgery moved smoothly.

The cardiac anesthesia team, led by Dr. Jasvinder Kaur Kohli, kept the patient stable throughout. The perfusion team, under senior perfusionist Jagdish Chandra, managed the heart-lung machine—quietly sustaining life while the heart itself was being repaired.

Globally, only a handful of such cases have been reported—and most relied on open surgery. Performing a complex heart repair through such a small incision in a patient with mirror-image anatomy is exceptionally uncommon. Doctors believe this could be among the first of its kind. Dr. Jhajhria said they may submit a paper about this case at the appropriate global forum.

For Reeta, the outcome brought relief.

Her recovery after surgery was smooth. Follow-up tests confirmed that the defect had been successfully corrected.

Calling it a proud moment, Dr. Ashok Kumar, Director of ABVIMS and RML Hospital, praised the collective effort of surgeons, anesthetists, perfusionists, nurses, and technicians.

The surgery was carried out under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, highlighting how public healthcare support is making advanced, life-saving treatments accessible to patients.