The mechanism of rheumatic aortic regurgitation is retraction of the three cusps leading to lack of coaptation. The authors describe a technique of aortic valve repair by extension of the cusps using autologous pericardium, undertaken in 52 patients (mean age 21 +/- 5 years) and report the short and medium term results. There were no operative deaths or reoperation for technical failure. The postoperative echocardiographic examinations showed absent or minimal aortic regurgitation in 45 patients (87%) and moderate regurgitation in 7 patients (13%). The echocardiographic results at 2 years were stable: no patient was reoperated for deterioration of the valvuloplasty. This technique is reproducible and reliable is selected patients.