Acute Coronary Occlusion in Patient With Congenitally Corrected Transposition of the Great Arteries— Wiring Towards the Unknown

As life expectancy in patients with congenital heart disease continues to increase, coronary artery disease and acute coronary syndromes are encountered more and more in this population, with a higher level of complexity, especially in the acute setting. We present a case of acute thrombotic occlusion of the left circumflex coronary artery in a patient with congenitally corrected transposition of the great arteries. This case highlights several challenges from ECG and computed tomography interpretation to coronary angiography and PCI performance. Key pre-procedural and procedural steps are revised to guide toward prompt and successful revascularization.