Abstract Dextro cardia is a rare heart condition of 0.37 to 0.53% 10,000 live births. 45 year old patient had successful double valve replacement (AVR and MVR) with moderate pulmonary hypertention in this anomaly and is extremely rare. The altered surgical anomaly and the necessary changes in surgical approach are described. This procedure is rarely done and is reported very few in the literature to our knowledge.