Reoperations in cardiac surgery are very difficult and risky due to possible complications. A 27-year-old female patient at 35 weeks of pregnancy applied to the cardiology department with a complaint of palpitation. In the control transthoracic echocardiography, a 24¥25 mm mass was detected in the right atrium. The patient had situs inversus totalis and had undergone a robotic atrial septal defect closure operation one year ago. After the cesarean operation, robotic cardiac surgery was performed on the beating heart, and the mass in the right atrium was successfully removed. During the procedure, the perfusion strategy was differently conducted than the normal patient management, and the perfusion device was located differently. Cardiac surgery with minimally invasive robotic surgery in a pregnant female with dextrocardia is a special condition that requires many changes in perfusion methods and protocols, and their coexistence create a difficult process for perfusionists.