Open AccessIatrogenic Bidirectional Dissection of the Right Coronary Artery and the Ascending Aorta: The Worst Nightmare for an Interventional Cardiologist
Author(s) -
Ziad Dahdouh,
Vincent Roule,
Thérèse Logé,
Rémi Sabatier,
Mathieu Big,
Guillaume Malcor,
Adrien Lemaître,
Katrien Blanchart,
Julien Wain-Hobson,
Vladimir Saplacan,
Fabio Cutone,
Dimitrios Buklas,
Calin Ivascau,
Massimo Massetti,
Gilles Grollier
Publication year - 2012
Publication title -
korean circulation journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.809
H-Index - 29
eISSN - 1738-5555
pISSN - 1738-5520
DOI - 10.4070/kcj.2012.42.7.504
Subject(s) - medicine , ascending aorta , dissection (medical) , cardiology , aortic dissection , right coronary artery , aorta , aortic valve , surgery , interventional cardiology , coronary angiography , myocardial infarction
Although rare, iatrogenic aortocoronary dissection is one of the complications most dreaded by the interventional cardiologist. If not managed promptly, it can have redoubted and serious consequences. Herein, we present the case of a 70 year-old woman who was treated by stenting of the second segment of the right coronary artery (RCA) for recurrent angina but, unfortunately, the procedure was complicated by anterograde dissection of the RCA with a simultaneous retrograde propagation to the proximal part of the ascending aorta. Successful stenting of the entry point was able to recuperate the RCA and to limit the retrograde propagation to the ascending aorta, but there was an extension of the dissection to the aortic valve leaflets resulting in a massive aortic insufficiency. Therefore, surgical aortic valve replacement with prosthetic tube graft was performed [corrected].