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Retrograde aortic dissections can be a complication of vascular procedures. We describe
a case of an inadvertent cannulation of the right common carotid artery during an
attempt at inserting a pulmonary artery catheter. This resulted in dissection of the
right common carotid, subclavian, and innominate arteries. Transesophageal echocardiography
was able to visualize a retrograde dissection extending back into the ascending aorta.