Ascending aortic dissection complicated by aorta-right atrial fistula is a very rare occurrence. The patient may present with atypical clinical findings such as a continuous murmur or atrioventricular block, making the diagnosis difficult. Surgical repair is straightforward unless the correct diagnosis is missed, in which case there may be difficulties during the initial period of cardiopulmonary bypass. This report deals with the successful management of a 67-year-old man with this condition
