Surgical repair of ascending aortic disease involving the aortic root most commonly involves the direct ana stomosis of the coronary ostia to the composite aortic graft. Occasionally, when direct aortocoronary ana stomosis is not safe or technically challenging--such as in cases of extreme aortic dilatation, calcification and reoperations--the Cabrol technique and its modification can provide a safe and effective alternative. As the Cabrol is often reserved as a second line or bailout procedure, there is insufficient evidence to support the optimal imaging assessment and follow up of patients who have undergone this complex aortic recon struction. We present the case of a patient where emergency replacement of the aortic root took place with a modified Cabrol aortocoronary anastomosis. We discuss the usefulness, findings and limitations of modern noninvasive imaging modalities that can provide a complete functional and anatomical assessment of this surgical technique.