The patient is described who developed a huge (12 x 10 x 9 cm) perigraft aneurysm after replacement of most of the ascending aorta with a graft containing a valve prosthesis and anastomosis of the coronary arteries directly to the Gortex graft. Detachment of the left main coronary artery to the composite graft appeared to be the cause of the perigraft aortic hematoma and aneurysm.
