|Home | About | Journals | Submit | Contact Us | Français|
A 68-year-old-female presented with acute chest pain, and was found to have an acute coronary syndrome (ACS). Coronary angiography demonstrated a significant lesion in the right coronary artery (RCA). Percutaneous coronary intervention was complicated by guide catheter-induced spiral dissection of the RCA, extending proximally to the coronary cusps and to a portion of the ascending aorta (figure 1). Stenting of RCA dissection was enough to seal the retrograde blood flow to the aortic portion of the dissection. Follow-up echocardiography revealed normal left ventricular function and a normal aortic root.
Coronary dissection is a well-known complication of coronary interventions (in our case due to deep seating of the guiding catheter); however, retrograde extension to the aortic root and ascending aorta is exceedingly rare, with an incidence reported as 0.02% of coronary angioplasties.1,2 Conservative management can be sufficient in cases with extension less than four centimetres into the ascending aorta.2-4
Both authors contributed equally to the literature search and to the preparation of this manuscript. We have no financial disclosure or conflict of interest to report.