Use of an apico-aortic conduit (AAC) serves as an altative method to treat severe aortic stenosis in elder patients,especially in those with a heavily calcified ascending aorta or prior cardiac surgery.The results of long-term follow-up of AAC are very rare.We reported a case about a successful replacement of late degenerated prosthetic valve following AAC procedure,assisted with extra corporeal membrane oxygenation (ECMO).