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A transverse aortotomy is fashioned approximately 0.5 cm above the sinotubular junction. It is important not to cross the STJ with the incision as this prevents distortion of the aortic valve with closure of the aortotomy, which can result in aortic insufficiency. The distal aorta at the incision line is then tacked to the pericardial reflection at the level of the SVC for exposure.
