Ventricular Septal Mass Formation After Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention

A 63-year-old woman with angina was admitted for percutaneous coronary intervention to a chronic total occlusion of the right coronary artery. Because 2 previous anterograde attempts had failed, the initial strategy was retrograde wiring of the multiple septal collaterals present. Fielder FC, Sion, and Sion Blue wires (Asahi, Japan) were used supported by a Corsair micro-catheter, but none of them could reach the distal right coronary artery because of the extreme tortuosity of the channels, especially in the last segment near the posterior descending artery (Figure 1A). An antegrade approach was then taken, successfully reaching the true lumen of the distal right coronary artery under contralateral guidance. Immediately after subsequent stent deployment an area of well-circumscribed and persistent contrast …