The Bentall procedure without the use of a prepared valved-conduit: a step backwards?

A repeat Bentall procedure or a Bentall procedure in an immobile aortic root such as a prior homograft that has calcified can be problematic. Separating the valve from the conduit and with a modified elephant trunk concept we have simplified the proximal graft anastomosis using a running suture technique. This is followed by coronary ostia implantation and then by lowering the aortic valve onto the aortic annulus using a running suture technique. doi: 10.1111/jocs.12078 (J Card Surg 2013;28:298300)