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Objective: To evaluate the effect of modified surgical techniques on hemostasis used in aortic root replacement with a composite graft (Bentall procedure). Methods: Data on 15 patients who underwent Bentall procedure during 2005 to 2007 were analyzed. The first 5 patients (Group 1) received the standard procedure. Then next 10 patients (Group 2) received the modified procedure. Techniques including tandem suture line, endo-button buttress, sandwich anastomosis and left ventricle filling were added to the standard procedure. Perioperative bleeding and the volume of blood transfusion required were compared to estimate hemostasis in different groups. Results: Between groups 1 and 2, a significant difference was found in postoperative bleeding [(2193±383) ml vs (1012±258) ml, respectively; P＜0.05] and in volume of blood transfusion required [(7242±1416) ml vs (2520±708) ml, respectively; P＜0.05]. Conclusion: The modified surgical techniques used in our study are effective in the improvement of the hemostasis in Bentall procedure.