INTRODUCTION
Iatrogenic aortocoronary dissection(IACD) is a fatal complication occurring in 0.02 - 0.04% cases1-2,6 of coronary catheterization that requires early recognition and emergent surgical treatment. Aortic dissection may lead to serious complications like myocardial infarction or sudden cardiac death. Most described cases occurred during catheterization and angioplasty of the Right Coronary Artery(RCA) 3-4. The morphological and structural differences between right and left coronary arteries may explain the fact that left aortic sinus is less prone to iatrogenic dissection5. Various options have been tried by many in the past including Coronary Artery Bypass Grafting(CABG) with aortic dissection repair, stenting the coronary artery, monitoring the aortic dissection using Transesophageal echocardiography(TEE), implanting coronary stents to maintain coronary blood flow before surgery and repairing aortic dissection surgically. Our patient had RCA Dissection which was extending to the ascending aorta with intramural hematoma. Reverse saphenous vein graft(RSVG) was used to revascularize the RCA with supracoronary replacement of the ascending aorta. Because of the significant disease in the proximal Left Anterior Descending Artery(LAD), a separate RSVG-LAD graft was also done.