Iatrogenic coronary artery dissection extending into the ascending aorta

One of the most feared complications of percutaneous coronary interventions is coronary artery dissection. Rarely, such dissections can propagate into the ascending aorta, which may then require surgical intervention. We present the case of a 50-year-old patient with new-onset angina and two-vessel coronary artery disease who underwent percutaneous coronary intervention on the right coronary artery, complicated by an iatrogenic coronary dissection extending into the ascending aorta. A decision was taken to perform emergent cardiac surgery due to ongoing chest pain and the extent of the dissection. Computed tomography after surgery revealed no signs of aortic dissection with normal dimensions in all aortic segments. The patient was discharged home in a stable condition.