title: Rotastenting in an anomalously arising right coronary artery after an ugly dissection.
abstract: Rotational atherectomy is contraindicated in dissected coronary arteries since it can lead to progression of the dissection or perforation. In our case, the right coronary artery (RCA) arose anomalously from the left coronary sinus. The lesion in the RCA was an undilatable calcified one. There was a dissection in the RCA due to high pressure balloon dilatation. Since the patient was hemodynamically unstable and there were no options besides rotablation, we proceeded with caution. Rotablation and stenting were successfully done. Our case report highlights the importance of the need for good guide catheter support even in the presence of anomalously arising arteries and the rotablation option for unyielding calcified coronary lesions, even in the setting of a dissection.
authors.affiliation: Interventional Cardiologist, Director of Cardiology, Jaslok Hospital and Research Centre, 15 Dr. G. D. Deshmukh Marg, Mumbai 400026, India. Electronic address: drmehta_a@yahoo.com.
authors.forename: Ashwin B
authors.initials: AB
authors.lastname: Mehta
authors.forename: Ajit
authors.initials: A
authors.lastname: Desai
authors.forename: Nihar
authors.initials: N
authors.lastname: Mehta
mesh_terms: D000368:Aged; D017225:Atherectomy, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000601:surgery*; D003330:Coronary Vessel Anomalies; D006801:Humans; D008297:Male
keywords: Anomalous coronary artery; Dissection; Rotablation; Undilatable calcified lesion