A modified technique of aortic root replacement with the pulmonary autograft is described with the purpose of eliminating native pulmonary artery tissue as a support structure for the autograft valve leaflets. Large coronary buttons are preserved to replace the native pulmonary sinuses completely, and the noncoronary aortic sinus is left in situ to externally buttress the noncoronary sinus of the pulmonary autograft.