Aortic dissection during heart transplant: when a nightmare comes true

: Although heart transplant is a simple surgical procedure, it is actually considered challenging to perform this procedure in patients with a long-term left ventricular assist device assistance. We present the case of a patient who was bridged to the transplant by using a Jarvik 2000 left ventricular assist device. During the debridement, an acute type A aortic dissection occurred and the surgical strategy was suddenly replanned. The acute aortic dissection is one of the most feared complications, but it could be well managed, thanks to a rapid replanning of the surgical strategy.