Catheter ablation is a curative and effective therapeutic option for idiopathic and symptomatic right ventricular outflow tract (RVOT) ventricular tachycardia (VT). However, cases of coronary artery injury during catheter ablation have been reported. 2, 3, 4 Anomalous aortic origin of the coronary artery (AAOCA) is a rare condition, usually associated with an abnormal trajectory of the involved vessels, being a “double-edged sword,” depending on whether the coronary artery is distant or close to the site of origin of the VT. Therefore, in these cases it is essential to determine the relationship between these structures to avoid iatrogenic damage to the epicardial vessels. There is only one reported case of successful ablation of RVOT VT in a patient with an anomalous aortic origin of right coronary artery (R-AAOCA), in which the artery ran very close to the ablation site (risk facto...

Shaggy aorta (SA) is characterized by a critical and extensive atheromatous disease of the thoracic and abdominal aorta. This degenerative and dangerous pathology is the result of the confluence of multiple modifiable and non-modifiable risk factors. The clinical importance of this pathology relies on the various syndromes that can develop from its etiopathogenesis, which generates great morbidity and mortality in the affected patients. In this document, we present an updated and detailed review of this entity, developing aspects of its pathophysiology, diagnosis, including the importance of multimodal imaging, and its therapeutic approach. Finally, we present the clinical settings of patients with SA in different aortic scenarios (aortic dissection, ulcerated plaques, and thrombosed aneurysms) that denote the nature of this disease and its high mortality.

Shaggy aorta (SA) is characterized by a critical and extensive atheromatous disease of the thoracic and abdominal aorta. This degenerative and dangerous pathology is the result of the confluence of multiple modifiable and non-modifiable risk factors. The clinical importance of this pathology relies on the various syndromes that can develop from its etiopathogenesis, which generates great morbidity and mortality in the affected patients. In this document, we present an updated and detailed review of this entity, developing aspects of its pathophysiology, diagnosis, including the importance of multimodal imaging, and its therapeutic approach. Finally, we present the clinical settings of patients with SA in different aortic scenarios (aortic dissection, ulcerated plaques, and thrombosed aneurysms) that denote the nature of this disease and its high mortality.

Shaggy aorta (SA) is characterized by a critical and extensive atheromatous disease of the thoracic and abdominal aorta. This degenerative and dangerous pathology is the result of the confluence of multiple modifiable and non-modifiable risk factors. The clinical importance of this pathology relies on the various syndromes that can develop from its etiopathogenesis, which generates great morbidity and mortality in the affected patients. In this document, we present an updated and detailed review of this entity, developing aspects of its pathophysiology, diagnosis, including the importance of multimodal imaging, and its therapeutic approach. Finally, we present the clinical settings of patients with SA in different aortic scenarios (aortic dissection, ulcerated plaques, and thrombosed aneurysms) that denote the nature of this disease and its high mortality.