Fig. 1

a The expansion of the aorta occurs on a multiplanar axis. b “Spiral” aortoplasty allows for the circumferential wall tension reduction along multiple planes. c The aortotomy is performed in a spiral fashion extending from the pulmonary bifurcation and down to the annulus of the non-coronary sinus. d The aortotomy is sandwiched between two strips of Teflon felt incorporating 0.5 cm of tissue on either side. e The proximal coronary grafts are implanted either above or below the suture line