Replacement of the aortic valve and the entire ascending aorta (modified Bentall's technique) was performed in 11 patients with annulo-aortic ectasia. Nine patients are alive and well postoperatively. In comparison with our previous surgical technique, by which the aortic root was left remaining without removal, the new technique required less bypass time, including less coronary perfusion time and less amount of intraoperative bleeding than the cases handled by the previous technique, whereas amount of postoperative bleeding in both groups was not significantly different. Details of the new technique were described and the advantages of this technique are security of intraoperative hemostasis as well as shortened operation time. The Björk-Shiley tilting disc prosthesis was really convenient for this surgical technique because of its low profil architecture, and also this prosthesis gives excellent postoperative results in combination with the new surgical technique.