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Percutaneous Transluminal Coronary Angioplasty for Morphologic Left Anterior Descending Artery Lesion in a Patient with Dextrocardia

A Case Report and Literature Review

Akihisa Tomaru, MD, PhD, FACA

Kenji Wagatsuma, MD

Makoto Kudo, MD

Jun Baba, MD

Kazutoshi Takikawa, MD

Otoya Miho, MD

Makoto Yoshikawa, MD, PhD

A case report of percutaneous transluminal coronary angioplasty (PTCA) to treat coronary atherosclerotic lesions in a patient with dextrocardia associated with situs inversus totalis is presented. The patient was a sixty-two-year-old man who was admitted with a diagnosis of congestive heart failure. Cardiac catheterization was performed. Left ventriculography showed mild hypokinesis in segments 2 and 3 with ejection fraction of 63%. Coronary arteriography revealed 74% stenosis in segment 7 of the left anterior descending (LAD) artery. PTCA for this lesion was performed. Successful dilation was achieved with the residual stenosis in the LAD reduced from 74% to 34%. Performance of PTCA in patients with dextrocardia is extremely rare, and only 8 cases have been reported to date. However, by visualizing the procedure as a mirror image and choosing a guide catheter that permits good engagement, it appears possible to perform it like ordinary PTCA.

Angiology, Vol. 48, No. 5, 451-456 (1997)
DOI: 10.1177/000331979704800509


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