γγIn the past, aortic regurgitation generally required valve replacement therapy. Currently, repair surgery is also available to correct regurgitation. Repair surgery has several advantages over valve replacement: 1) no lifelong anticoagulation is required, eliminating all complications of anticoagulation; 2) fewer foreign bodies are implanted, reducing the risk of endocarditis; and 3) degenerative changes in the own valve occur less frequently than in biological valves.γγA number of important structures in the aortic root are jointly involved in the closure of the aortic valve. The aortic root consists of the sinotubular junction, the aortic sinus, the aortic valve leaflet, and the aortic annulus. Therefore, when one or more of these structures fails, aortic valve insufficiency can result. While valve replacement is certainly the most convenient approach in the event of aortic valve insufficiency, preservation of the valve itself is more beneficial to the patient’s long-term quality of survival. Therefore, clinically, for patients with aortic valve closure insufficiency, the above factors affecting valve closure should be analyzed comprehensively and addressed symptomatically for the greater benefit of the patient. Currently, aortic valve closure insufficiency is attributed to several aspects: sinotubular junctional dilatation, sinus dilatation, aortic valve abnormality, and annular enlargement. Preoperatively, the above structures can be analyzed by ultrasound to understand the main causes of the lesions, and the different conditions can be addressed, during surgery. The corresponding surgical techniques include, artificial vessel replacement to narrow the sinus junction, sinuplasty, aortic valve suspension and folding, aortic valve patch repair, aortic annulus reduction, etc., which have achieved good clinical results in the near and long term.