Normal aortic root: The re-implantation of the coronary arteries is prone to complications, and aortic root replacement should be avoided when possible. The aortic valve and ascending aorta can be replaced in separate steps, without root replacement. Normal aortic valve with annular dilation and ascending aneurysm (frequently found in Marfan syndrome): Artificial heart valves may wear out or require anticoagulation, and a valve-sparing aortic root replacement allows replacement of the aortic root +/- ascending aorta, while allowing a person to keep their own aortic valve and avoid the problems of aortic valve replacement.