A 69-year-old man underwent thoracic endovascular aortic repair (TEVAR) for type B subacute aortic dissection (AD) to prevent its false-lumen expanding. The patient complained of a fever and malaise 19 months after the TEVAR. Ga-67 scintigraphy showed accumulation of radioactivity at the thoracic aortic stent graft (TA-SG). Infection of the TA-SG was diagnosed, and antibiotic therapy was initiated. Although the patient’s condition was improved temporarity, he was readmitted three times for exacerbation of the infection. The patient presented with back pain 31 months after the TEVAR. Computed tomography showed migration of the distal end of the TA-SG, and additional TEVAR was performed. A month after the additional TEVAR, the patient was admitted with toothache and headache after tooth extraction on the same day. Despite a lack of chest symptoms, the patient suddenly fell into cardiopulmonary arrest in the next day and died. In autopsy, there were two aorta-esophageal fistulae (AEF), pus discharge between the TA-SG and the aortic wall, and aortic root rupture. Rupture of type A acute AD with an entry away from the proximal end of the TA-SG (i.e., independent of the TA-SG) was diagnosed. Even though persistent bacteremia is latent, it may cause fistulae or dissections in the aortic wall through mechanisms such as inflammatory-cytokine expression or vasa-vasorum embolism. In the present patient, it is considered that TA-SG infection-induced bacteremia was relevant to AEF and leading to the type A acute AD. Although it is often difficult to be diagnosed without typical symptoms such as hematemesis, AEF and other aortic diseases caused by aortic fragility should be kept in mind in case of persistent bacteremia after TEVAR.