de Bellaing AM, Pontailler M, Bajolle F, et al. - Given a rare requirement of the aortic root and ascending aorta replacements (AARs) in the pediatric population, researchers here report a series of AAR performed in young children using different surgical techniques. From 1995 and 2017, AAR procedures were undertaken in 32 children under the age of 10 years (median age 5.4 years) at their institution. A connective tissue disease (infantile Marfan syndrome or Loeys–Dietz syndrome) was reported in 22 (69%). A composite graft with a mechanical prosthesis was used to perform 11 AAR and valve-sparing procedures (10 Yacoub operations and 11 David operations) were undertaken in 21 patients. Outcomes support the safety of performing aortic root and AARs in young children irrespective of the surgical procedure. Good long term outcomes were achieved with aortic valve-sparing procedures except in children with infantile Marfan syndrome whose ineluctable aortic annulus dilatation or aortic valve regurgitation required reintervention after a short period.