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Iatrogenic bidirectional dissection of the right coronary artery and the ascending aorta: the worst nightmare for an interventional cardiologist

机译：右冠状动脉和升主动脉的医源性双向解剖：介入心脏病专家最糟糕的噩梦

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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.
机译：尽管很少见，医源性主动脉冠状动脉夹层术是介入心脏病专家最害怕的并发症之一。如果不及时处理，可能会造成严重后果。本文中，我们介绍了一名70岁女性，她通过右冠状动脉第二节（RCA）的支架置入术治疗复发性心绞痛，但不幸的是，该过程因同时行RCA的顺行解剖而变得复杂逆行传播至升主动脉的近端。入口点的成功支架置入能够使RCA恢复，并限制逆行向升主动脉的扩散，但是解剖范围扩大到主动脉瓣小叶，导致主动脉瓣功能不全。因此，进行了孤立的外科主动脉瓣置换术。

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