This video demonstrates the Gaudiani technique for aortic valve replacement with ascending aortic replacement in an 82-year-old patient with aortic stenosis and an ascending aorta measuring more than 5cm in size.   

To begin, the femoral vein was cannulated, and direct cannulation was performed as the dilated aorta ended before the innominate artery.  

The ascending aorta was fully resected distally and proximally to the sinotubular junction.  

A silk suture was placed at each commissure, and the valve was excised. Interrupted valve 2.0 sutures were placed in a horizontal mattress starting between the left and right commissures, with some pledgeted sutures being utilized.   

The valve was secured, followed by the suturing of the Dacron graft to both the proximal and distal aorta, thus completing the operation.   

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