Abstract
A case of annulo-aortic ectasia involving the aortic arch and the proximal part of the left subclavian artery is reported. The aorta was replaced with a composite graft (Björk–Shiley tilting disc valve and very soft Cooley low-porosity prosthesis) and the coronary ostia and the innominate and left common carotid arteries were implanted directly into the prosthetic tube. The patient recovered without complications.