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Direct minimally invasive approach for aortic root replacement.

The author describes a minimally invasive approach for aortic insufficiency associated with severe calcification of the ascending aorta. The Bentall operation was easily performed through an 8 cm skin incision affording excellent exposure of the operating field, and with the use of CPB with vacuum-assisted venous drainage and clamping the aorta with a Casgrove flex clamp.