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Objective To evaluate the effectiveness of modified Bentall procedure for aortic root aneurysm related to Marfans syndrome.Methods Between July 1999 and August 2009, 36 consecutive Marfans syndrome patients with aortic root aneurysm underwent aortic root replacement.Patients were divided into two groups according to the surgery procedures.Modified Bentall procedures was performed in 20 patients (group M), and conventional Bentall operation were performed in 16 patients (group C).The clinical outcomes were observed.Results The in-hospital mortality was 6.3%, including one patient died of multi-organ failure 4 day after operation in group M.The volume of blood loss in Group C (839.5±95.4)ml was significantly more than that in Group M (428.0±66.8)ml).One patient in group C required reexploration of the chest for bleeding complications.Patients had longer intra-operative aortic cross-clamp times (103.7±29.3)min vs.(90.6 ±24.5)min, cardiopulmonary bypass times (166.2 ±32.5)min vs.(145.4 ±28.0)min, and operative times (237.4±79.3)min vs.(210.2±64.7)rnin in group C than group M, but the differences were not statistically significant (P >0.05).Postoperative drainage volume and the volume of blood transfusion required were less in group M than group C 420.6±236.4 ml vs.615.3±259.6 ml, and 2.0±0.8U vs.4.8±2.1U, (P < 0.05).The time of follow-up was 2~98 moths and the survival rate was 100%.Two patients required reoperation for distal descending aorta replacement because of descending aortic extension.Conclusions The modified Bentall procedures is an excellent method for aortic root aneurysm related to Marfans syndrome, and it can improve hemostasis and shorten operation time.The technique can be considered as a useful and alternative operation approach.