Aortal dissection is an emergency and life endangering incident. It is a longitudinal discission of the arteri-al wall where blood is coming and creates a haematoma and as a result of that the arteria arches outwards. There is created a double lumen - a proper one and a falše one. It is established mostly on the basis of con-genital inferiority of the media. In the period of gravidity the disease is mostly manifested in the 3rd tri-mester and in early puerperium. In our čase it was a 34 years old ill woman who was in her 22nd week of gravidity. During her first gravidity there was found hypertension, gestational diabetes and preeclampsia. Due to hypertension she was cured with metropol. At present she has been admitted because of a very inten-sive pain on the chest and breathing problems. According to TTE there was found a strong aortal regurgi-tation and a small pericardial exudate. With a suspect dissecting aneurysm of the thoracic aorta she was sent to the coronary unit of the internal clinic. Within a 5-day stay here the aortal dissection (TTE, TEE, spirál CT) was not proved and in the end, the patient was removed to the gynecological obstetric clinic. Sudden-ly, the eighth day of her hospitalization a consciousness disorder with hypertension and bradycardia appe-ared. She was sent back to the coronary unit mentioned above. After some examinations there was revea-led a clear acute dissection of the ascending aorta (TEE, angio CT) and was turned over to a cardiosurgical intervention. After the previous section she was given Bentall operation (substitution of aortal valve and ascending aorta). In the early postoperative period she was cured with a combined hypotension medication. On the 6th postoperative day on CT of the abdomen she was found with a tumor in her left kidney and was indicated left-sided nephrectomy. Lifelong anticoagulant therapy was indicated. On the 21st postoperative day she was sent back to the gynecological clinic and after a week she was discharged from hospital in good condition. When dismissed she was cured with metropol and warfarin. Our čase report shows an atypical example of thoracic aorta dissection in the gravidity period with a postponed diagnosis and a successful cardiosurgical intervention

        Key words: aortal dissection - pregnancy - thoracic aorta - hypertension - Bentall operation - renal tumor