Doctor Nguyen Van Duong, from the Interventional Cardiology Center at Tam Anh General Hospital, Ho Chi Minh City, stated that Mr. Trong suffers from situs inversus, a condition affecting one in 10,000 people. In this condition, the patient's heart is located on the right side instead of the left, and major organs in the chest and abdomen are symmetrically reversed.

"In over two decades of interventional cardiology, I have only encountered a few similar cases," said doctor Duong.

Coronary angiography results revealed that the patient had 80-90% narrowing of the left anterior descending artery and 90% narrowing of the intermediate branch (an extended branch of the left coronary artery). Severe calcification affected the entire coronary system, posing a high risk of myocardial infarction and cardiac arrest.

Doctor Duong noted that the altered anatomical structure made coronary intervention challenging. Images on the screen appeared completely reversed, with the left coronary artery running to the right and vice versa. Angulation, the origin points of blood vessels, and the direction of instrument movement were all atypical.

According to doctor Duong, the rare occurrence of dextrocardia necessitates a thorough examination of the coronary artery structure before stent placement in each intervention. The team employed high-resolution optical coherence tomography (OCT) to assess the thickness of calcified plaques and the length of the narrowed segments, guiding the selection of appropriate angulation, guidewire direction, and stent type.

Subsequently, doctors performed balloon angioplasty to compress calcified plaques against the vessel wall, creating a path for the sequential placement of two stents in the left anterior descending branch and one stent in the intermediate branch. Post-intervention, doctors optimally dilated the severely narrowed vessel segments, eliminating blockages that caused myocardial ischemia. The stents expanded well, adhering closely to the vessel walls, minimizing the risk of restenosis.

Doctors used OCT to visualize blood vessels, assisting in stent placement to widen the patient's coronary arteries. Photo: Tam Anh General Hospital

Mr. Trong suffered from multiple cardiovascular and metabolic conditions, including ischemic heart disease, hypertension, type 2 diabetes, and dyslipidemia, for which he had been taking medication for many years. Three days post-intervention, his health stabilized, and he was discharged.

To reduce the risk of disease recurrence, doctor Duong advised the patient to adhere to medical treatment, maintain a healthy lifestyle (quit smoking, limit alcohol consumption, increase physical activity, avoid stress), follow a heart-healthy diet, manage underlying conditions, and attend scheduled follow-up appointments.

Thu Ha

*Patient's name has been changed