CORONARY - Complex and Higher Risk Procedures for Indicated Patients (CHIP)
Multi-vessel PCI in a Patient with Dextrocardia Done from Radial Approach
Mohd Asyiq Al-Fard bin Mohd Raffali1, Shawal Faizal Mohamad1, Patrick WJ Tiau1, Diyana Farouk1, Hamat Hamdi Che Hassan1
Pusat Perubatan Universiti Kebangsaan Malaysia, Malaysia1,
We present a 67 years old gentleman with underlying hypertension, dyslipidemia and congenital dextrocardia. He previously had multiple PCI done to the left anterior descending and left circumflex arteries for acute coronary syndromes in January 2018 and April 2020. On the latest admission in November 2020, he had PCI done for persistent angina. The patient had severe bilateral knee osteoarthritis that made him unable to proceed with femoral access if deemed required.
Chest radiograph showed dextrocardia.
Dextrocardia is a rare occurrence for our regular PCI practice, with prevalence study showed it to be 0.22% of the population. Image adjustment such as inverting the image is warranted to smooth the process of doing the procedure. We reported a case in which a multi-vessel PCI is feasible to be done with the trans-radial approach and with zero to minimize complications.