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- W2163762193 abstract "A 70-year-old man presented at the emergency room with right-sided chest pain. The patient had known situs inversus totalis and dextrocardia, together with a 20-year history of type 2 diabetes mellitus. A right-sided electrocardiogram revealed 1-mm ST-segment elevation in the inferior leads. A chest radiograph confirmed dextrocardia and situs inversus. His troponin level was 8.1 ng/mL upon his admission to the emergency room. The patient was transferred to the cardiac catheterization laboratory for primary angioplasty. The door-to-balloon time was 75 minutes. The left coronary artery was engaged with a 6F Judkins left 4 diagnostic catheter without difficulty. The anatomic left anterior descending coronary artery displayed a 70% proximal lesion, followed by occlusion at the mid segment. The large diagonal coronary artery had a 60% stenosis at the proximal segment (Fig. 1). The left circumflex coronary artery was angiographically normal (Fig. 2).Fig. 2 Left coronary angiogram (left anterior oblique view) shows a normal left circumflex coronary artery (arrow).Fig. 1 Left coronary angiogram (right anterior oblique view) shows the occluded left anterior descending coronary artery (LAD) and a 60% stenosis of the diagonal artery.An attempt was made to engage the right coronary artery (RCA) by counterclockwise rotation of a 6F Judkins right 4 diagnostic catheter, but the vessel was occluded and impassable at the proximal segment (Fig. 3). Therefore, a multipurpose catheter was used in the RCA as a guiding catheter. The RCA lesion was crossed with a floppy guidewire and dilated with a 2 × 20-mm semicompliant balloon catheter, after which a 3.5 × 18-mm stent was successfully deployed (Fig. 4).Fig. 4 Right coronary angiogram (right anterior oblique view) shows final result after stent deployment.Fig. 3 Right coronary angiogram (right anterior oblique view) shows occluded right coronary artery (arrow)." @default.
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- W2163762193 date "2012-01-01" @default.
- W2163762193 modified "2023-09-23" @default.
- W2163762193 title "Primary percutaneous intervention: for acute myocardial infarction in a patient with dextrocardia and situs inversus." @default.
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