Experience with a new operation for patients with aortic valve disease and aneurysm or dissection of the ascending aorta is described. Twenty-four patients aged 66-87 years were operated on using a subcoronary implantation technique with a stentless aortic valve bioprosthesis and an extension using a vascular tube prosthesis. No major adverse cardiac events were observed in the postoperative period. This operation offers a safe alternative to the technically more demanding procedures of composite bioprosthetic ascending aortic replacement or full root replacement.

Subcoronary implantation of the Medtronic stentless bioprosthesis and an extension using a vascular tube prosthesis provide a safer alternative to the more invasive conventional composite graft replacement or a full root replacement using a homograft or a stentless valve. The advantage lies in eliminating the need for coronary mobilisation and anastomosis which actually lead to the increased risk in those procedures.