Alternative and Safe Technique to Tie Down a Biologic Aortic Valve in Small Aortic Roots

Biologic aortic valves are constructed with 3 stents corresponding to the commissures, which sit in the aortic root. When implanted using interrupted sutures, these stents may make the valve difficult to tie down safely in patients with small, calcified aortic roots. We present an easily reproducible technique to make this valve tie down safer.