ISSN 1755-5302 Interventional Cardiology Case Report Interventional-Cardiology.655 © 2020 Background Dextroversion of the heart is a type of dextrocardias, the heart is located in the right hemithorax without inversion of chambers. Tis congenital anomaly is the result of a counter-clockwise rotation of a normally developed heart in the right hemi thorax. It may be associated with diferent cardiac and pulmonary anomalies, or may be isolated. It has been described under diferent names: dextrorotation [1], isolated dextrocardia [2], dextrocardia with atria in situs solitus [3]. In 1998 Hakim et al., reported a case of ASD transcatheter closure in a case of dextrocardia with situsin versus, they used left atrium angiogram in the right anterior oblique view with cranial angulation to visualize the IAS, followed by successful positioning of Amplatzer device across the defect [4]. Maldjian et al., studied a case of isolated dextroversion by MSCT in 2006 and described that the right atrium was posterior and to the right of the left atrium. Te morphologic right ventricle was posterior, slightly superior and to the right of the morphologic left ventricle [5]. In dextroversion, the interatrial septum is directed to the right, with the morphologic right atrium situated to the right and slightly posteriorly, and the morphologic left atrium to the left and slightly anteriorly. Galal et al., reported successful closure of fenestrated septum by Amplatzer cribriform device in a case with situs solitus and dextrocardia, they reported difculty in device positioning, yet with no specifc technique recommended [6]. Case Presentation We present a case of a female patient 3-year- Transcatheter ASD closure in a patient with Dextroversion: A case report Background: Cardiac dextroversion is location of the heart in the right chest with the left ventricle remaining in the normal position to the left but lying anterior to the right ventricle. To the best of our knowledge no specifc technique has been described before for successful transcatheter secundum atrial septal defect closure in patients with dextroversion. Case presentation: We present a case of secundum ASD in a patient with dextroversion, situs solitus, AV concordance and VA concordance. Patient was referred for transcatheter closure of ASD. Her transthoracic echocardiography showed a 7 mm secundum ASD, Upper normal RV size, small restrictive VSD 2 mm and a dilated main pulmonary artery. Transesophageal echocardiography showed an 11 mm defect with abnormal orientation of inter atrial septum due to cardiac dextroversion. Usual technique for positioning of ASD Amplatzer device (ASO 11) failed with prolapsing of the device into right atrium. Failed right upper pulmonary vein technique. With successful positioning of the device across the interatrial septum using left upper pulmonary vein technique. Conclusion: We recommend left upper pulmonary vein technique for safe and direct positioning of ASD device across interatrial septum in patients with dextroversion. Keywords: Congenital heart disease  Left upper pulmonary vein  Dextrocardia Abbreviations: 2D: 2 Dimensional; ASD: Atrial Septal Defect; ASO: Atrial Septal Occluder; AV: Atrioventricular; CXR: Chest X-ray; ECG: Electrocardiography; IAS: Interatrial Septum; LUPV: Left Upper Pulmonary Vein; MSCT: Multislice Computed Tomography; PA: Pulmonary Artery; PR: Pulmonary Regurgitation; RA: Right Atrium; RUPV: Right Upper Pulmonary Vein; RV: Right Ventricle; TEE: Transesophageal Echocardiography; VA: Ventriculoarterial; VSD: Ventricular Septal Defect Yasmin Abdelrazek Ali 1 *, Alaa Mahmoud Roushdy 1 , Khaled Ahmed Shams 2 , Noha Mohamed Gamal 3 1 Department of Cardiology, Ain Shams University, Cairo, Egypt 2 Department of Cardiology, Helwan University, Helwan, Egypt 3 Department of Cardiology, Assuit University, Assiut, Egypt *Author for correspondence: Yasmin Abdelrazek Ali Email: yasminabdelrazek@med.asu. edu.eg Received date: May 05, 2020 Accepted date: May 19, 2020 Published date: May 26, 2020 Interv. Cardiol. (2020) 12(3), 78–82 7 8