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A 31-year-old woman with Marfan syndrome required aortic root repair for annuloaortic ectasia in the 16th week of her first pregnancy. Aortic root reimplantation was successfully performed with a higher-flow-rate cardiopulmonary bypass of 3.4-3.6 l/min/m at normothermia for fetal survival. During the surgery, a cardiotocography and transesophageal echo probe attached on the patient's abdomen allowed adequate monitoring of the fetal heartbeat. The postoperative course was uneventful, and a healthy baby was delivered by cesarean section at 37 weeks' gestation. [ABSTRACT FROM AUTHOR]