A middle-aged knitting mechanic under went replacement of his mitral valve with a Bjork-Shiley prosthesis as well as insertion of multiple autogenous saphenous vein grafts to bypass the occluded coronary arter ies. Eight months after cardiac surgery, the patient was re-evaluated because of transient ischemic attacks. Repeat studies revealed a normally functioning mitral disk prosthesis and aortic dissection involving the descend ing and transverse arch with the saphenous vein graft emerging from the outer lumen. It was decided to continue to treat him con servatively, and he has been doing well for 14 months.
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