Aortic root and extensive coronary dissections complicating recanalization of chronic right coronary artery occlusion: refraining from stenting may have a favorable outcome!

Aortic root dissection is a rare, potentially life-threatening complication of revascularization procedures. We report a case of recanalization of chronic total occlusion of the right coronary artery. A huge coronary dissection with a false lumen was created using commercially available guidewires during attempts to establish a connection with the distal true vessel lumen. In addition, an aortic root dissection from the right coronary cusp occurred. The patient was asymptomatic and a decision was made to refrain from stent deployment in order not to close communications between the false, true lumen and branches. The hospital stay was uneventful and the patient was discharged on conservative management. Control angiography at 3 months revealed patency of the right coronary artery with complete healing of the aortic wall dissection and improved clinical status of the patient.