Aortic Valve Repair :  In, acquired AR associated with VSD and prolapse of a cusp, repair is often successful. VSD is closed and at the same time the prolapsed part of the cusp is repaired through the aortic root (Trussler's). A few surgical groups have repaired aortic valves that are rheumatic or myxomatous. Generally these procedures involve plication of commissaries, purse string narrowing of LV-aortic junction or excising portions of the cusp and suture reconstruction. Some patients may need pericardial cusp enhancement. When dissecting aneurysm extends into the aortic annulus causing gross AR, at times the valve can be saved by reusepension. In one of the larger series freedom from re-operation after repair was 84 per cent in seven years. Aortic valve could be replaced with a prosthetic or bio prosthetic valve.