Aortic valve repair has become an attractive alternative to aortic valve replacement in most of the patients with aortic insufficiency.To improve reproducibility and durability "geometric anatomy" of the valve has been developed to guide the repair.Expert centers were able to publish remarkable short-and long-term results for aortic valve sparing procedures.Therefore, data comparing composite valve grafting and aortic valve sparing procedures revealed similar early mortality.Also, late mortality, thromboembolism, stroke and bleeding risks were significantly lower in patients undergoing aortic valve repair and late durability was equivalent 1 .However, the complexity of the procedures makes aortic valve repair difficult to be adopted into daily surgical practice.Accordingly, starting your own aortic valve repair program requires conviction, training, facilities, quality control and a well structured heart valve team to let your program succeed.