A 61-year-old female, who had undergone the surgical treatment of acute type A aortic dissection with a ringed intraluminal graft 26 years before, presented with breathlessness. Computed tomography (CT) showed peri-prosthetic leakage and enlargement (45×50 mm in diameter), enlargement of the aortic root (42 mm in diameter), and aneurysm of the ascending aorta and the aortic arch (55 mm in diameter) with chronic type A aortic dissection. Echocardiography showed severe aortic regurgitation. She successfully underwent aortic root replacement( Bentall procedure) and total arch replacement.

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