Coronary dissection is an extremely rare but known complication of
coronary catheterization and angioplasty. Due to its rarity, there are
no management recommendations. However, surgery immediately after an
endovascular procedure is frequently carried out under major
antithrombotic treatment. The surgery and the postoperative consequences
are therefore very complex. We report here the documented case of a type
A aortic dissection after coronary catheterization. Despite extension to
the entire ascending aorta which indicated surgical management, the
benefit-risk balance argued for armed surveillance to avoid surgery
under antiplatelets drugs without known antidote. We believe this case
should lead us to systematically weigh the data before considering that
any iatrogenic dissection of Dunning class 3 should be operated.