Bilateral Opposing Loop Technique for Securing Air Knots

Incompletely seated knots (air knots) during surgical aortic valve replacement can be potentially difficult to repair in anatomically challenging areas around the aortic root. That is especially true with mechanical protheses as subvalvular areas are inaccessible once the valve is seated. In this report, we present a novel and simple technique of tightening air knots from within the aortic root without removing the prosthesis.