Sinner Gregory J, George Bennet, Messerli Adrian W
Division of Cardiovascular Medicine, 900 South Limestone Avenue, CTW Building RM 320, Lexington, KY 40536-0200 USA.
J Invasive Cardiol. 2019 May;31(5):E83-E88. doi: 10.25270/jic/18.00351.
Patients with dextrocardia present unique challenges in the catheterization laboratory. Variable coronary artery anatomy impacts percutaneous access, catheter selection and manipulation, and image acquisition. This is a review of all published reports of radial artery access for diagnostic and/or therapeutic coronary interventions in patients with dextrocardia. We conclude that the radial approach is safe and effective in these patients and should be used without hesitation. In addition, interventionalists should consider use of multipurpose catheters and possess an understanding of how mirror-image fluoroscopy impacts catheter manipulation. Furthermore, we propose a stepwise approach to arterial access, fluoroscopy, and catheter selection for operator reference while treating dextrocardia patients.
