Ascending aortic dissection complicated by aortic right ventricular fistula.

This is a case of a man in his 60s with a history of previous aortic valve replacement, atrial fibrillation and non-ischaemic cardiomyopathy, who presents with a Stanford type A aortic dissection. The patient underwent emergent ascending aorta replacement. Intraoperatively, a large, dissected aneurysm was found. The false lumen, located between the aorta and PA, extended and perforated into the right ventricular outflow tract. The dissection originated from the previous surgical aortotomy line, with a component located at the right coronary ostium. Hence, the patient underwent successful ascending aortic replacement, patch repair of his aorto-cameral fistula and primary repair of the right coronary ostium.