Limits...
Triple-vessel percutaneous coronary revascularization in situs inversus dextrocardia.

Kakouros N, Patel SJ, Redwood S, Wasan BS - Cardiol Res Pract (2010)

Bottom Line: 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 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.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins University, Baltimore, MD 21205, USA.

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.

No MeSH data available.


Related in: MedlinePlus

Coronary angiograms pre and post coronary intervention (left and right columns, resp.). Panels (a, b): Left anterior Oblique (LAO) caudal view showing lesion in large obtuse marginal (white arrow) and severe stenosis of LAD (black arrow), Panels (c, d): PA cranial view showing severe LAD stenosis prior to (c) and post intervention (d). Panels (e, f): Left-sided right coronary. artery in Right anterior oblique (RAO) view.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2902043&req=5

fig2: Coronary angiograms pre and post coronary intervention (left and right columns, resp.). Panels (a, b): Left anterior Oblique (LAO) caudal view showing lesion in large obtuse marginal (white arrow) and severe stenosis of LAD (black arrow), Panels (c, d): PA cranial view showing severe LAD stenosis prior to (c) and post intervention (d). Panels (e, f): Left-sided right coronary. artery in Right anterior oblique (RAO) view.

Mentions: Coronary angiography was performed via the right femoral artery. The anatomical left coronary system (right sided) was cannulated with a 6-French Judkins Left 4 catheter. The transverse angles (right/left obliques) were reversed whilst keeping the cranial/caudal tilts the same. A critical lesion was noted in the mid-left anterior descending (LAD) artery with a further significant stenosis at the proximal part of a large first obtuse marginal branch (Figure 2). The left-sided anatomical right coronary artery (RCA) was cannulated with a 6-French Judkins Right 4 catheter using counterclockwise rotation. There was a long segment of significant disease in the mid vessel and a focal lesion just before the crux (Figure 2).


Triple-vessel percutaneous coronary revascularization in situs inversus dextrocardia.

Kakouros N, Patel SJ, Redwood S, Wasan BS - Cardiol Res Pract (2010)

Coronary angiograms pre and post coronary intervention (left and right columns, resp.). Panels (a, b): Left anterior Oblique (LAO) caudal view showing lesion in large obtuse marginal (white arrow) and severe stenosis of LAD (black arrow), Panels (c, d): PA cranial view showing severe LAD stenosis prior to (c) and post intervention (d). Panels (e, f): Left-sided right coronary. artery in Right anterior oblique (RAO) view.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2902043&req=5

fig2: Coronary angiograms pre and post coronary intervention (left and right columns, resp.). Panels (a, b): Left anterior Oblique (LAO) caudal view showing lesion in large obtuse marginal (white arrow) and severe stenosis of LAD (black arrow), Panels (c, d): PA cranial view showing severe LAD stenosis prior to (c) and post intervention (d). Panels (e, f): Left-sided right coronary. artery in Right anterior oblique (RAO) view.
Mentions: Coronary angiography was performed via the right femoral artery. The anatomical left coronary system (right sided) was cannulated with a 6-French Judkins Left 4 catheter. The transverse angles (right/left obliques) were reversed whilst keeping the cranial/caudal tilts the same. A critical lesion was noted in the mid-left anterior descending (LAD) artery with a further significant stenosis at the proximal part of a large first obtuse marginal branch (Figure 2). The left-sided anatomical right coronary artery (RCA) was cannulated with a 6-French Judkins Right 4 catheter using counterclockwise rotation. There was a long segment of significant disease in the mid vessel and a focal lesion just before the crux (Figure 2).

Bottom Line: 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 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.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins University, Baltimore, MD 21205, USA.

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.

No MeSH data available.


Related in: MedlinePlus