Between 1987 and 1995, 50 patients underwent replacement of the ascending aorta and aortic valve by a composite graft with a mechanical valve. 3 patients had annuloaortic actasia, 1 had sinus valsalva aneurysm, 14 patients had DeBakey type I acute dissection, 14 had DeBakey Type II acute dissection, including 6 with Marfan's syndrome, and 18 had atherosclerotic aneurysms. Up to one month after operation 6 patients (12%) died. The mean duration of follow-up was 52 months. 36 patients were restudied by clinical examination and computed tomography of the chest. Three patients required re-operation because of pseudo-aneurysm formation or disruption of the proximal aortic anastomosis and right coronary anastomosis. Two of them had Marfan's syndrome. Those 3 patients underwent emergency re-operation. Anastomotic dehiscence of the composite graft has a potentially high risk of fatal complications. We suggest that the complications may occur not only early postoperatively. Follow-up by computed tomography should be performed, in our opinion, regulary every 6 to 12 months after composite graft replacement.

Keywords: Aortic dissection, Surgery, aortic aneurysm, follow-up, computed tomography