Successful surgical repair of Marfan aneurysm of the aortic root represents one of the major developments in the specialty of cardiovascular surgery over the past 30 years. Prior to 1968, we did not have a suitable operation for Marfan aneurysm of the aortic root such as depicted here. This is a 10 cm diameter Marfan aneurysm viewed from the head of the operating table with the heart seen beyond the aneurysm. Elective operative repair of Marfan aneurysms of the aortic root was rarely performed before 1968. Surgeons usually waited until these aneurysms dissected or ruptured. At the Johns Hopkins Hospital, for example, only five patients with Marfan aneurysm of the ascending aorta were operated upon between 1965 and 1976. Four patients came to the operating room with a rupturing or dissecting aneurysm. Three of these patients died and one patient who had an elective operation for severe heart failure survived.