case_images: PMC10764205_01
case_images: Coronary angiography images. (A) Intact left coronary artery without collateral blood supply into the right coronary artery (RCA). (B) Aortocoronary dissection of RCA with total occlusion.
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case_images: While the left coronary system was intact (Fig. 1A), the coronary dissection spread retrogradely from the right sinus of Valsalva to the ascending aorta after injecting contrast into the right coronary artery (RCA). The RCA was completely occluded at the proximal part, and no collateral flow into the RCA was observed (Fig. 1B).
case_images: Preoperative electrocardiography. ST elevation in leads II, III, and aVF, and reciprocal ST depression in leads I, aVL, and V4-6 were detected.
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case_images: Electrocardiography revealed previously undetected ST elevation in leads II, III, and aVF and reciprocal ST depression in leads I, aVL, and V4-6 (Fig. 2).
case_images: Preoperative contrast-enhanced CT. (A) Ascending aortic dissection is detected. Contrast-material is pooled in the false lumen. (B) Dissection at the proximal part of RCA is suspected (black arrow).
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case_images: Contrast-enhanced CT confirmed aortic dissection which was localized in the ascending aorta (Fig. 3A). Additionally, RCA occlusion at the proximal portion was suspected (Fig. 3B).