We present the case of a 52-year-old with a history of aortic valve replacement and replacement of the ascending aorta with the graft inclusion technique presenting with dizziness and collapse. Computed tomography and coronary angiography revealed pseudoaneurysm formation at the anastomotic site causing aortic pseudostenosis. Due to severe calcification of the graft inclusion surrounding the ascending aorta, we performed a redo ascending aortic replacement using a two-circuit cardiopulmonary bypass to avoid deep hypothermic cardiac arrest.