The pathway was slightly different for a patient who presented directly at the hub hospital (Fig. 3). He was a 55-year-old man, hospitalized in the pink area of the ER. He had chest pain that had started 30 min earlier that irradiated to the interscapular area and to the left arm. He had diabetes, an ascending aortic aneurysm and previous vascular correction of an isthmic aortic coarctation. An echocardiogram showed subendocardial ischaemia. The TTE showed severe aortic regurgitation and normal cardiac function. The chest CT scan showed a 3-mm increase in the known aortic root aneurysm, absence of critical coronary stenosis and no signs of COVID-19. The results of the nasal swab were negative. The patient was hospitalized in the coronary unit area of the green path and discussed in the THT, finally approved as ND. Three days later, he had a Bentall-De Bono procedure with the implant of an aortic biological prosthesis (29 mm) sutured to a 30-mm diameter aortic root Valsalva prosthesis using cardiopulmonary bypass. After the procedure he was transferred to the green area of the ICU; 3 days later he was readmitted to the green area of the ward. Due to new chest pain, he had a CT scan, diagnostic for right pulmonary artery thromboembolism (no haemodynamic instability on the TTE). Adequate therapy was introduced and after 5 days, following a CT scan (negative for disease progression), he was discharged.