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KMID : 0368120120420070504
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Korean Circulation Journal
2012 Volume.42 No. 7 p.504 ~ p.506
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Iatrogenic Bidirectional Dissection of the Right Coronary Artery and the Ascending Aorta: The Worst Nightmare for an Interventional Cardiologist
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Ziad Dahdouh
Vincent Roule
Therese Lognone
Remi Sabatier
Mathieu Bignon
Guillaume Malcor
Adrien Lemaitre
Katrien Blanchart
Julien Wain-Hobson
Vladimir Saplacan
Fabio Cutone
Dimitrios Buklas
Calin Ivascau
Massimo Massetti
Gilles Grollier
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Abstract
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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, an isolated surgical aortic valve replacement was performed.
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KEYWORD
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Coronary angioplasty, Coronary dissection, Ascending aorta
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