Abstract
An 87-year-old woman had residual moderate to severe aortic insufficiency following transcatheter aortic valve replacement. A year later, she developed extensive Stanford type A aortic dissection originating at the supra-annular aortic edge of the transcatheter aortic valve replacement nitinol frame. Dissection repair, frozen elephant trunk with exclusion of prior insufficiency while preserving the transcatheter aortic valve replacement valve was performed. (Level of Difficulty: Beginner.).