The cardiac surgery team in the Belfast Trust have performed the first Personalised External Aortic Root Support (PEARS) operation in Ireland. The team led by Mr A Graham and Dr D Glasgow performed the successful operation this week. The surgical team were supported by Professor John Pepper of the Royal Brompton Hospital, London who performed the first ever PEARS and who has done more of these operations than any other surgeon. The operation is used to treat aortic root aneurysm which is common, and potentially life threatening, in inherited conditions such as Marfan’s Syndrome. The traditional surgical approaches are to replace the aortic root and implant the coronary arteries and either replace the aortic valve (Bentall’s procedure) or re-implant the patient’s own aortic valve in the aortic graft (valve sparing root replacement – VSRR). In PEARS a tailor made external stent is made for the patient and wrapped around the aortic root and ascending aorta. The external stent will prevent future expansion of the aorta and there is evidence that it gets incorporated into the aortic wall which strengthens it and helps prevent aortic dissection in the future. The patient in Belfast was number 83 in the world and will be closely followed up the PEARS registry. Although, the alternative treatments of Bentall’s or VSRR are well established with proven track records, PEARS offers an additional option for treating aortic root aneurysm which may be preferable for some patients with this condition.