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A 74-year old male presented with a dilatation of the thoracic aorta late after an acute aortic dissection. Computed tomography (CT) showed chronic dissecting aortic aneurysms just below the distal aortic arch. The total descending thoracic aorta was surgically replaced. Four weeks later, a massive bloody effusion developed in the right thorax and a subsequent CT scan revealed an extravasation of the contrast material out of the vascular prosthesis. Emergency surgery disclosed bleeding from a small vascular graft rupture and a successful repair was performed.

The life-threatening complication of a vascular graft rupture early after a thoracic aortic replacement