Management of coronary artery disease by percutaneous coronary intervention in patients with situs inversus dextrocardia: A single-center experience

Situs inversus dextrocardia is an unusual congenital cardiac anomaly that presents technical challenges to cardiologists for coronary interventions. The objective of this study was to report a single-center experience of 8 cases of coronary artery diseases (CAD) among patients with situs inversus dextrocardia, successfully managed by percutaneous coronary intervention (PCI). The study sample comprised of 8 patients with situs inversus dextrocardia, with a mean age of 54.25 ± 12.44 years, treated at a tertiary care center between 2008 and 2022. Revascularization was done with drug-eluting stents (DES) in 7 patients and with bioabsorbable vascular scaffold (BVS) in 1 patient. The outcome measures comprised of the presence of residual stenosis and thrombolysis in myocardial infarction (TIMI) flow grade. The final angiogram confirmed no significant residual stenosis and established TIMI grade III flow. At follow-ups ranging from one month to 14 years, 6 patients were asymptomatic. One patient had new onset lesion in another vessel, 10 years after the index procedure requiring stenting. One patient had mild recoil in the treated segment, which was managed conservatively. CAD in patients with situs inversus dextrocardia can be successfully managed by PCI with some technical modifications such as selection and manipulation of catheters, mirror image projection, and angulations.