59-year-old woman with Marfan syndrome wasreferred for cardiac computed tomography withechocardiographic diagnosis of sinus of Valsalva aneu-rysm. Twenty years earlier, she had had an aortic typeA dissection. A mechanical prosthesis and a 30-mmsupracoronary graft were implanted. The right coronaryartery was reimplanted. Cardiac computed tomographyshowed a 10 7.8 cm aneurysm arising from the left sinusof Valsalva (Fig 1; note the descending aortic dissection[arrow] and the previous reimplantation of the rightcoronary artery [arrow]). Reintervention preserved themechanical prosthesis, and the aortic root was replaced.Coronary arteries were reimplanted following Cabrol’stechnique. Most sinus of Valsalva aneurysms are congen-ital.Acquiredaneurysmsarecausedbyconditionsaffectingthe aortic wall, such as infection, degenerative disease,or thoracic trauma [1]. In our case, although Marfan syn-drome was the main condition, prior replacement of thesupracoronary aorta alone can also be followed by recur-rent aneurysm formation at the level of the residual aorticroot. As regards diagnostic tools, echocardiography andcardiac computed tomography are complementary.