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

Dextrocardia poses challenges in the percutaneous coronary intervention, particularly through radial access. The presence of chronic total occlusion further adds to the technical difficulties in such cases due to unfamiliar orientations of the coronary arteries, guide catheter instability, and problems in advancing the hardware across the occluded lesions. We report here a successful percutaneous intervention in a chronic total occlusion of the left anterior descending coronary artery, done through right radial access in a patient with situs-inversus and dextrocardia. The trans-radial percutaneous intervention approach is safe and feasible in patients with dextrocardia. Pre-planned imaging strategies and the choice of appropriate hardware tremendously help in successfully completing the intervention in such cases.