Prosthetic Valve Removal Technique Using Ultrasonic Scalpel.

Prosthetic valve removal for reoperative valve replacement is time consuming and has a risk of damage to the heart because of severe adhesions. Prosthetic valves can be removed quickly, easily, and safely by using an ultrasonic scalpel (Harmonic Scalpel, Ethicon Endo-Surgery, Cincinnati, OH). The space between the prosthesis and the native annulus was carefully dissected using Harmonic Synergy blades connected to an Ethicon Gen11 Generator at energy level 5. The average time for prosthetic valve removal using an ultrasonic scalpel was 6 minutes 11 seconds. No patient required new permanent pacemaker implantation.