Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 7 2015 10 06 444 447 EN Feridoun Sabzi Department of Cardiovascular Surgery, Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, Iran Donya Khosravi Department of Gynecology and Obstetrics, Preventive Gynecology Research center, Imam Hussein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran 2015 10 06 2015 10 06 We report a unique case of chronic dissection of the ascending aorta complicated with huge and thrombotic pseudoaneurysm in a patient with coarctation of descending aorta. Preoperative investigations such as transesophageal echocardiography (TEE) confirmed the diagnosis of dissection. Intraoperative findings included a12 cm eccentric bulge of the right lateral side of dilated the ascending aorta filled with the clot and a circular shaped intimal tear communicating with an extended hematoma and dissection of the media layer. The rarity of the report is an association of the chronic dissection with huge pseudoaneurysm and coarctation. The patient underwent staged repair of an aneurysm and coarctation and had an uneventful postoperative recovery period. https://acta.tums.ac.ir/index.php/acta/article/view/4285 https://acta.tums.ac.ir/index.php/acta/article/download/4285/4240