Schematic diagram of the operation. (A) A vertical slit of the graft corresponding to the estimated distance from the aortoventricular junction to the bottom of the left main trunk and a round opening were created from the bottom to midpoint. And the graft was cut longitudinally over the entire length at the marked position corresponding to the right coronary artery. (B) A wrapping graft as "neo-adventitia" is seated down after multiple subannular inside-out sutures of 4–0 polypropylene sutures with Teflon pledgets were placed in a horizontal mattress fashion. (C and D) Transsectional and external diagrams show after completion. LCA: left coronary artery; RCA: right coronary artery.