A 19-year-old woman suffering from Atrial Septal Defect (hole in the heart) and Dextrocardia with Situs Inversus Totalis, an extremely rare congenital condition (happens once in 12,000 births) in which the heart, lungs, liver, stomach, and gallbladder are a mirror image of the normal anatomy underwent an open heart surgery at Narayana Multispeciality Hospital, for repairing the cardiac defect. Sazia* from a remote village near Mysore was leading a normal life until few months ago, when she started experiencing frequent episodes of tiredness and chest discomfort. An initial check-up at a local hospital revealed a startling diagnosis of multiple congenital complications, including a hole in the heart and abnormal placement of visceral organs in her body. As a result of this, doctors were unsure of performing a surgery on her since her anatomy was complicated and highly uncommon. Another critical factor that added to the complication was the patient’s rare blood group (O negative). At Narayana Multispeciality Hospital, the surgical team headed by Senior Cardiac Surgeon Dr. M.N Ravi took-up this challenging case and devised a thorough surgical strategy to perform open heart surgery, using her own blood. Dextrocardia that affect the heart function can cause a variety of symptoms such as breathing difficulties, fatigue with heart defects and blue lips and skin. The symptoms are consistent with defects in the ventricles of the heart. Lack of oxygen in the heart can make the patient tired and may prevent in growth as well. Explaining about the surgery, Dr. M.N. Ravi, Senior Cardiac Surgeon, Narayana Health Mysore said, “Usually in an open heart procedure, the surgeon accesses the heart from the right side ,standing to the right of the patient as it is pointing towards the left. However in this case, as the patient’s heart and chambers were in the reverse location, we decided to operate on the heart from the other side.The positioning of the heart lung machine was also changed. We also collected her own blood and transfused back during the surgery, which is not common.” A surgeon gets to treat such cases very few times and we were quite confident of successfully performing this rare and challenging surgery”, added Dr. Ravi. The defect was repaired and closed successfully in a three-hour-long surgery. The patient was comfortably able to sit and eat a light meal the same evening, and was discharged three days post surgery. Experts treating her are confident about her full and speedy recovery. She will also be able to resume her household work in about four week’s time, and without any further restrictions she will be able to lead a normal family life thereafter.