This is a case of a 47 year old female patient presenting with congestive heart failure (NYHA Class III). Echocardiography showed a tricuspid aortic valve with grade III aortic insufficiency and computed tomography scan showed an aneurysm of the aortic root and the ascending aorta with a maximum diameter of 60 mm. A valve sparing aortic root replacement (David procedure) was performed through an upper partial sternotomy.