Dextrocardia is a rare congenital cardiac anomaly where the base-apex axis of the heart is directed to the right side. It may be associated with situs solitus, situs inversus, or situs ambiguous. Here we report a case of a patient with dextrocardia and situs inversus totalis, who had severe aortic bioprosthetic valve degeneration needing a redo aortic valve replacement. Computed tomography scan played a crucial role for a proper preoperative anatomical evaluation and surgical planning. Regarding our operative strategy, the main surgeon stood on the left side of the patient to perform most surgical steps. This surgical management played an important role for the good result in this challenging scenario.