A 55-year-old man was referred to our hospital for hemolytic anemia 21 months after an ascending aortic replacement for acute type A aortic dissection. The enhanced CT revealed an aortic pseudoaneurysm formation at the proximal anastomosis. The cause of hemolysis was verified to be the pressure by an aortic pseudoaneurysm formation at the vascular graft stenosis. At the reoperation, the previous vascular graft was found to have partially detached from the aortic stump over the non-coronary cusp. Ascending aortic replacement was performed with a tailoried vascular graft in a scallop shape, corresponding to the non-coronary cusp. The postoperative course was uneventful and hemolysis diminished soon after the operation.