A 41-year-old man with a prosthetic aortic valve developed endocarditis with perivalvular leakage, formation of an abscess, and left ventricular-aortic discontinuity, 16 months after aortic valve replacement. Moreover, he developed a complicated huge dissecting ascending aortic aneurysm with thrombotic occlusion of the right coronary artery. Successful repair of this complicated aortic root lesion was achieved using a composite valved graft and employing coronary bypass grafting.
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