We previously described using a “Y” incision and rectangular patch to enlarge the aortic annulus by 2-3 valve sizes for aortic valve replacement (AVR) with bioprosthesis (1) or mechanical valve (2) in patients with trileaflet aortic valve (TAV). As we are becoming more experienced, we are able to enlarge the aortic annulus by 4 valve sizes routinely in either TAV or bicuspid aortic valve (BAV). In this video we used a case of TAV to...