An unusual complication of coronary angiography: bidirectional dissection of the right coronary artery and the ascending aorta.

Iatrogenic aortocoronary dissection is a rare but devastating complication of percutaneous coronary interventions. The authors present the case of a 45 years old woman admitted for anginal chest pain. She underwent coronary angiography and developed complete anterograde dissection of the right coronary artery simultaneously with retrograde extensive propagation to the ascending aorta. Failure to attempt stenting because of altered hemodynamics and intractable chest pain prompted an emergent bypass surgery with treatment of the aortic dissection. Causes and modalities of treatment of iatrogenic aortocoronary dissections are discussed.