Iatrogenic right coronary artery dissection with retrograde extension to the right coronary sinus

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Cardiology

Background:

• Iatrogenic coronary artery dissection is a rare but serious complication.
• Diagnostic coronary catheterization carries inherent risks, including arterial dissection.
• Extension of dissection into the aorta presents significant management challenges.

Observation:

• A 46-year-old male developed right coronary artery dissection during diagnostic coronary catheterization.
• The dissection propagated retrogradely, involving the right coronary sinus.
• This rare event highlights the potential for iatrogenic injury to extend beyond the initial site.

Findings:

• The patient's iatrogenic coronary artery dissection extended into the aorta.
• Successful treatment involved coronary artery bypass grafting (CABG).
• Surgical repair of the aortic dissection was also performed concurrently.

Implications:

• This case underscores the importance of recognizing and managing rare iatrogenic vascular injuries.
• Coronary artery bypass grafting and aortic repair can be effective for complex dissections.
• Improved techniques and vigilance during coronary catheterization are crucial to minimize such risks.