Pseudoaneurysm formation with aorto-right atrial fistula due to coronary button total detachment is a late and unusual complication of the Bentall procedure. In this article, we report a 43-year-old male case who underwent the Bentall procedure for bicuspid aortic valve and ascending aortic aneurysm 11 years prior. The connection on the right atrium was primarily sutured and the defect of the ascending aorta was closed with a Dacron graft. The thrombosed right coronary artery ostium was ligated with saphenous vein grafting. Normothermia was achieved and the patient was weaned from the cardiopulmonary bypass uneventfully.