Although it is a rare occurrence, aortic dissections can rupture into the cardiac chambers or great vessels. A review of The English literature revealed only 3 cases of fistula between an aortic false lumen and the main pulmonary artery that were repaired successfully. in this article, we report the case of a chronic type I aortic dissection with an aortopulmonary artery fistula. The patient presented with congestive heart failure. One year earlier he had undergone aortic valve replacement. To our knowledge, this is the 4th case of a successfully repaired type I aortic dissection with rupture into the pulmonary artery and the Ist such case involving a patient who had undergone a previous cardiac operation.