The changes and improvements in the surgical treatment of aortic valve disease in 296 patients, who were operated on between 1953 and 1965, are illustrated and discussed in general terms. Several of the early techniques, such as transventricular dilation, insertion of a homograft aortic valve in the descending thoracic aorta, fabric replacement of one cusp or the entire valve, and ice-chip arrest of the heart, are now obsolete. Total replacement with a ball-valve prosthesis or an aortic valve homograft while the coronary arteries are perfused with blood is the currently popular technique. The results of a hemodynamic follow-up study two years after surgery are also included.