Bhambhani Anupam, Joshi Amey
Cardiology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND.
Cureus. 2021 Mar 19;13(3):e13991. doi: 10.7759/cureus.13991.
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.
右位心给经皮冠状动脉介入治疗带来挑战，尤其是经桡动脉入路时。由于冠状动脉方向不熟悉、导引导管不稳定以及器械通过闭塞病变推进困难，慢性完全闭塞的存在进一步增加了此类病例的技术难度。我们在此报告一例通过右桡动脉入路，对一名右位心合并右位心患者的左前降支冠状动脉慢性完全闭塞成功进行经皮介入治疗的病例。经桡动脉经皮介入治疗方法对右位心患者是安全可行的。预先规划的成像策略和合适器械的选择对成功完成此类病例的介入治疗有极大帮助。
