Bailout retrograde wiring.

TVD. CABG refused by pt.
started from RCA. After predil. guide and wire came out. while re-engagement. there was an ostial dissection of rca extent retrograde into the aorta. multiple attempts to access the true lumen failed with various wires. PT had chest pain. so decided to fix the lcx first. then retrograde wiring from lad to cross into RCA and then into the aorta. retrograde wire snared and the guide was engaged into the true lumen after that it was routine PCI.
PT remained stable and now after several months, she is asymptomatic.

[@wolverineyt3764]

Was there dissection in aortic cusps? I can see some contrast stain hanging up there

[@ivankoshkin837]

Definitely there was