How should I treat a retrograde dissection of the aortic sinus of Valsalva during a percutaneous coronary intervention?

BACKGROUND: A 53-year-old man presented with unstable angina and was found to have an occluded right coronary artery (RCA). A dissection of the aortic sinus of Valsalva (ASV) resulted from the retrograde extension of a dissection of the RCA by an angioplasty guidewire. INVESTIGATION: Diagnostic angiography, laboratory test, electrocardiography, echocardiography DIAGNOSIS: Iatrogenic dissection of the ASV from the retrograde extension of a dissection of the RCA, leading to total occlusion, by an angioplasty guidewire. TREATMENT: Medical therapy at discharge and during follow-up; laboratory test; electrocardiography; echocardiography; stenting of the occluded RCA with spontaneous re-appearance of distal blood flow two weeks later.