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A patient underwent heart transplantation for dilated cardiomyopathy 17 years previously. The donor was a 14-year-old girl with no known cardiovascular disease. In 2005, on routine imaging, the patient was found to have an ascending aortic aneurysm. The condition progressed over the next three years, leading to moderate aortic insufficiency and severe aortic dilation. Figure 1 shows severe aortic dilation, clearly ending at the anastamosis of the donor and the recipient aorta (indicated by the arrow). Figure 2 is an aortogram taken in the cardiac catheterization laboratory. The pigtail catheter is seated in the aortic root. Injection of contrast highlights the severity of the ascending aneurysm. Cases of donor aortic aneurysm, although very rare, are described in the literature and can be due to donor atherosclerosis, connective tissue disease or infection. The patient underwent successful valve-sparing aortic root and ascending aorta replacement.