72 y/o Caucasian male was admitted to the hospital due to acute aortic dissection (De Bakey typ I), after physical exertion (Figure 1 and 2). Pt was previously operated on 19 y/a after sever anterior MI (LAD-lima) and 3 y/a was operated on as a ReDo case (3xCABG: LIMA was recycled to the LAD, and SV grafts were implanted to RCA and CxOM1). In ReReDo surgery ascending aorta was replaced with prosthetic graft, and RCA SF graft was re-implanted to prosthesis (Figure 3). Pt was discharged on the PO day#8 w/o complications.