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Abstract Type A aortic dissection (TAAD) can be complicated by myocardial ischemia due to extension of the dissection into coronary artery or by extrinsic compression of a coronary artery by the false lumen. We present the successful surgical management of a hemodynamically unstable patient with acute aortic dissection with ongoing myocardial ischemia by stenting the left main system prior to the surgical repair of TAAD. (J Card Surg 2011;26:634-635)