Continuous suture technique: Monofilament 2'0' prolene sutures, which slide through easily, are used for this technique. three double armed prolene sutures are taken and with valve kept outside the aorta on a holder, all the loops re taken on the aortic annulus and the skirt of the valve. The valve is lowered at the same time as the loops are pulled and tightened using nerve hooks. Once valve is seated all loose loops are tightened. The ends of the sutures at the three commissures are tied and cut off. If necessary, the valve can be rotated after it has been fixed.