Article Text

Download PDFPDF

Spontaneous right coronary artery dissection
  1. C S R Baker,
  2. C Knight,
  3. A Deaner
  1. csrbaker{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

A 44 year old woman presented with an eight month history of recurrent exertional chest and back pain. A diagnosis of Marfan syndrome had been made in 1985; in 1988, following the discovery of a chronic type A dissection, she underwent a Starr Edwards aortic valve and ascending aortic replacement with reimplantation of the coronary arteries.

On this presentation magnetic resonance scanning showed a dissection flap extending across the aortic arch that had been present and stable for 13 years. Myocardial perfusion scanning demonstrated a reduction in tracer uptake in the inferior wall. Coronary angiography revealed a spontaneous distal right coronary artery (RCA) dissection in a tortuous vessel (panel A, black arrow). The RCA was cannulated using a 6 French Judkins right guide catheter and two guide wires. Direct stenting of the lesion was performed uneventfully with a 3.5 × 23 Sonic stent (Cordis) (panel B, white arrow). Following the procedure the patient remains well.

Embedded Image