Seven patients with annuloaortic ectasia were treated according to the method described by Bentall and De Bono. A Björk-Shiley valve in a composite graft was the prosthesis of choice and was used in all patients except 1, who received a Starr-Edwards valve. Profound topical cooling without selective coronary perfusion was applied in 5 patients for myocardial preservation during aortic occlusion. The was 1 operative death and 1 late death, the latter from cerebral thromboembolism. Five survivors have been followed from 1 year 5 months to 2 years 10 months with an average follow-up of 2 years. Excellent results were obtained in all survivors, their physical capabilities putting them in Class I of the New York Heart Association Functional Classification. Postoperative aortograms showed no signs of kinking or compression of vascular prostheses nor abnormalities of prosthetic calves. A modified technique to secure graft fixation is discussed.