Type A dissection of the ascending thoracic aorta during percutaneous coronary intervention

Retrograde dissection of the aorta is extremely rare during percutaneous co ronary intervention (PCI), but is a recognized and potentially life-threate ning complication. We describe a case in which retrograde dissection of the aorta, necessitating urgent surgical repair, occurred during an attempt to open an occluded right coronary artery. Initially localized, the dissectio n extended during an attempt to seal the right coronary ostium, Our experie nce suggests that if localized aortic retrograde dissection occurs, the man agement will depend on the stability of the distal coronary vessel. If stab le, a conservative approach may be preferable to an attempt to seal the dis section.