Triple vessel percutaneous coronary intervention in a patient with situs inversus dextrocardia using a transradial approach

Abstract

Situs inversus dextrocardia is a challenging situation for an interventional cardiologist. This report presents a rare case where multivessel percutaneous coronary intervention was performed in a single sitting using transradial approach. The challenges encountered in the procedure and clues to successful outcome are discussed.

Transradial Coronary Intervention in Chronic Total Occlusion in a Patient With Mirror Image Dextrocardia

“…In order to review the techniques used by other operators in successfully performing PCI through TRA in the presence of mirror-image dextrocardia, we searched the databases of PubMed, PubMed Central, Google Scholar, and Cochrane for similar case reports. A total of 11 publications [1][2][3][4][5][6][7][8][9][10][11] were identified ( Table 1), reporting PCI on 17 lesions in 13 patients. Five successful PCIs were reported on occluded vessels [1,4,10,11].…”

“…Goel and Moorthy were the first to describe the usefulness of the double image inversion technique in dextrocardia [6], which we also used in our case. Although no other operator reported use of the double inversion, six operators described the ease of doing PCI by horizontally reversed positioning of the camera [1,4,[6][7][8][9] and in one report [10], the imaging details were not mentioned. Back-up support catheters were preferred in all cases and EBU catheter, with counter direction rotations, successfully cannulated LCA in most cases.…”

Revascularización miocárdica completa con injertos arteriales en un paciente con dextrocardia

“…El primer caso de revascularización miocárdica en paciente con dextrocardioca fue descrito por Grey y col. en 1981. 3 Desde entonces, pocos casos de pacientes con dextrocardia y enfermedad coronaria han sido reportados, lo cual nos motivó a contar nuestra experiencia. Paciente con dextrocardia y situs inversus totalis llevado a revascularización miocárdica quirúrgica con injertos arteriales.…”