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We present a case to demonstrate the feasibility of transapical beating heart mitral valve repair in a patient with dextrocardia. This minimally invasive technique provides simple, safe and satisfactory mitral repair. The surgical technique, outcome and prognosis are not affected by the condition. © The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.The hub-and-spoke semantic representation theory posits that semantic knowledge is processed in a n