Facilitated insertion of the Hancock II bioprosthesis

Prosthetic replacement of the aortic valve is the definitive therapy for patients with end-stage aortic stenosis and most patients with aortic insufficiency. In some valves, deflection of the stents can result in permanent deformation with resultant valvar insufficiency. The Hancock II porcine bioprosthesis is a second generation device with a low pressure fixation porcine valve that is mounted on a Delrin stent, which can be deflected without compromising the valve. A simple technique that aids in valve insertion, visualization of the sewing ring, and tension-free closure of the aortotomy is described.