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A 37 year old man with Marfan’s syndrome complained of a second episode of sudden chest pain. He had undergone Bentall’s operation at another hospital because of a diagnosis of Stanford type A aortic dissection. Enhanced computed tomography showed a three channelled aortic dissection in the thoracic descending aorta, having one occluded lumen and two patent lumens (fig 1A). The former was a thrombosed false lumen deriving from the previous dissection, and the latter was a new dissection from the previous true lumen (fig 1B). This case indicates that thrombus of the false lumen in a patient with chronic aortic dissection does not always mean a stable condition. Two years later he died suddenly of an unknown cause.