Recently, a patient with coronary artery disease and hypertension combined with aortic regurgitation underwent a successful non-extracorporeal cardiac nonstop, coronary artery bypass plus sinotubular junction reconstruction and aortic valvuloplasty. Due to the anatomical peculiarities of the three aortic valve leaflets, aortic valvuloplasty is one of the internationally recognized challenges and a more advanced surgical procedure. This patient’s postoperative esophageal ultrasound showed almost no regurgitation and perfect alignment of the three valve leaflets. When discussing the surgical options, it was considered that this patient had hypertension-induced dilatation of the ascending aorta, which in turn led to an enlargement of the “portal” of the aortic annulus, making it impossible to completely close the aortic valve and creating central severe regurgitation, but the valve leaflets themselves were of good texture and it would be a pity to replace the valve. The director of cardiac surgery, Qiang Zhao, decided to preserve the valve and perform a more difficult aortic valvuloplasty. During the operation, Director Zhao performed coronary artery bypass under non-extracorporeal circulation and non-stop heartbeat, and used artificial vessels to wrap around the ascending aorta and reshape the sinotubular junction, just like shaping a “waist seal” for the enlarged aorta, which in turn made the originally enlarged aortic annulus “door frame “The aortic valve leaflets can be well aligned because of the resulting reduction in size. This surgical approach minimizes the trauma associated with extracorporeal circulation and surgical procedures, and does not replace the prosthetic heart valve while obtaining the best quality of life for the patient. The postoperative esophageal ultrasound showed good aortic sinus morphology, and the aortic regurgitation basically disappeared. The patient was awakened and extubated 5 hours after surgery and returned to the general ward the next day. The traditional treatment for aortic valve lesions is valve replacement, but with the increasing demand for quality of life and the development of surgical techniques, aortic valvuloplasty is becoming more and more widely used, and some large international cardiac centers have already reported cases of aortic valvuloplasty with better near- and mid-term outcomes. It is well known that lifelong anticoagulants are required after mechanical valve replacement to avoid thrombosis, which not only increases the financial pressure of frequent blood tests and medication dispensing, but also greatly reduces the quality of life of the patient. Aortic valvuloplasty, on the other hand, uses its own heart valve without the use of anticoagulants and without prosthetic valve-related complications such as bleeding, embolism and prosthetic valve endocarditis caused by anticoagulant therapy, resulting in a high quality of life for the patient and a low reoperation rate in the near to mid-term, which can achieve satisfactory clinical outcomes. Moreover, aortic valvuloplasty is 30% less costly than conventional aortic valve replacement. Aortic valvuloplasty is currently indicated only for aortic valve lesions with good leaflet texture and requires a high level of skill on the part of the surgeon. The basis of aortic valvuloplasty has been studied for many years, and the clinical application of this technique is continuously explored, and is currently one of only a few cardiac centers in China that can perform this type of procedure. The center selects the appropriate surgical technique according to the patient’s specific pathological changes to individualize the valvuloplasty procedure and improve the success rate of the procedure. We have completed dozens of aortic valvuloplasty cases, ranking among the top in China, with a success rate of more than 95% and the longest post-operative follow-up period of 4 years, with no re-operations yet.