There are now many surgical alternatives available for repairing the aortic valve, depending on whether the primary problem is one of stenosis or insufficiency. Patients with insufficiency of the common truncal valve have a unique anatomic substrate, which in some cases allows an innovative strategy of repair not available for the typical patient with a diseased aortic valve. Surgeons should be aware that there are a large number of techniques described for repair of the aortic valve. Some of these are shown in Table 1. For repair of the truncal valve, in contrast, fewer techniques have been described. As shown in Table 2, they are significantly different than those available for repair of the aortic valve.