As its name indicates, this procedure is used for the replacement of the aortic root and ascending aorta only. The aortic valve is not replaced. However, it is re-implanted inside the Dacron tube graft, and both coronary arteries are re-attached to the Dacron. This procedure is primarily suitable for patients with trileaflet aortic valves with minimal aortic insufficiency. It may also be used in Marfan syndrome patients if their aortic annulus is not too dilated. Some patients with bicuspid aortic valve also may undergo this operation, if the leaflets are normal.