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Updated: Jun 10, 2026
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Triple-vessel percutaneous coronary revascularization in situs inversus dextrocardia
Nikolaos Kakouros1, Sundip J Patel, Simon Redwood
1Johns Hopkins University, Baltimore, MD 21205, USA.
Insights
Dextrocardia with situs inversus patients, despite a higher risk of congenital heart disease, have a similar coronary artery disease risk. This case demonstrates the first successful total triple-vessel coronary revascularization using percutaneous stenting in such a patient.
Area of Science:
- Cardiology
- Medical Genetics
Background:
- Dextrocardia with situs inversus affects ~1 in 10,000 individuals.
- 20% of these patients have primary ciliary dyskinesia (an autosomal recessive trait).
- While congenital heart disease is common, coronary artery disease risk is similar to the general population.
Observation:
- A 79-year-old woman with situs inversus dextrocardia presented with symptoms suggestive of cardiac ischemia.
- Standard diagnostic and interventional techniques were adapted for her unique anatomy.
Findings:
- Successful total triple-vessel coronary revascularization was achieved via percutaneous coronary intervention (PCI) with stent implantation.
- Specialized techniques including counter-rotation and transversely inversed image acquisition were employed.
- The procedure was performed using standard guide catheters.
Implications:
- This represents the first reported case of successful complex PCI in a patient with situs inversus dextrocardia.
- Right-sided chest pain should be considered a potential indicator of cardiac ischemia in this population.
- The findings support the feasibility of advanced interventional cardiology procedures in patients with dextrocardia and situs inversus.
Abstract:
Dextrocardia with situs inversus occurs in approximately one in 10,000 individuals of whom 20% have primary ciliary dyskinesia inherited as an autosomal recessive trait. These patients have a high incidence of congenital cardiac disease but their risk of coronary artery disease is similar to that of the general population. We report what is, to our knowledge, the first case of total triple-vessel coronary revascularization by percutaneous stent implantation in a 79-year-old woman with situs inversus dextrocardia. We describe the successful use of standard diagnostic and interventional guide catheters with counter rotation and transversely inversed image acquisition techniques. The case also highlights that the right precordial pain may represent cardiac ischemia in this population.
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