Trans-radial primary percutaneous coronary intervention in dextrocardia using double inversion technique

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Imaging

Background:

• Dextrocardia with situs inversus presents unique anatomical challenges for percutaneous coronary intervention (PCI).
• Abnormal cardiac location, mirror-image aortic arch, and unusual coronary origins complicate standard PCI procedures.
• Navigating these complexities requires specialized techniques for vascular access, catheter engagement, and radiological interpretation.

Purpose of the Study:

• To describe the successful application of a novel technique for PCI in a patient with dextrocardia and situs inversus.
• To highlight the utility of the "double inversion technique" in overcoming anatomical challenges during PCI in dextrocardia.
• To emphasize the preferred radial artery approach for PCI in dextrocardia patients.

Main Methods:

• A case report of a patient with dextrocardia and situs inversus presenting with acute ST-elevation myocardial infarction.
• Successful primary percutaneous coronary intervention using a trans-radial approach.
• Application of the "double inversion technique" for managing complex coronary anatomy.

Main Results:

• The patient with dextrocardia and situs inversus underwent successful trans-radial primary PCI.
• The "double inversion technique" facilitated accurate interpretation of coronary anatomy and effective intervention.
• The left radial artery approach was identified as technically advantageous due to the mirror-image aortic arch.

Conclusions:

• Percutaneous coronary intervention in dextrocardia patients can be successfully performed using specialized techniques.
• "Double inversion technique" offers a viable solution for interpreting and intervening on complex coronary anatomy in dextrocardia.
• The left radial artery approach may be preferred for PCI in dextrocardia patients.