Ascending aortic pseudoaneurysm (AAP) is a rare but serious complication after cardiothoracic surgery. Patients typically present with chest pain, fever, or mass effects, but asymptomatic individuals with abnormal imaging results have been reported. Currently, there are no established guidelines regarding the management of AAP, but most authors recommend surgical treatment even in asymptomatic patients. Here, we describe a 39-year-old woman with Marfan syndrome who developed an AAP approximately 7 years after cardiac surgery. She was treated conservatively and remained asymptomatic until the past 2 years when she developed progressive chest pain and dyspnea upon exertion. Computed tomography angiography, coronary angiography, and ascending aortography were performed and revealed the presence of a pseudoaneurysm of the ascending aorta. Surgical intervention was successful and she was discharged home without significant issues.
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