Perforation of the left ventricle during dissection of the intramuscular left anterior descending coronary artery—delayed presentation

Dissecting out a deep intramuscular left anterior descending coronary (LAD) artery during coronary artery revascularization requires surgical experience. Inadvertent entry into the right ventricle had been reported during such dissection previously. However, entry into the left ventricle (LV) has not. Here, we present a case where such an entry occurred and was successfully repaired.The patient presented ten years later with delayed rupture of the LV.