Safety-Net Balloon Technique for Pledget Retrieval in Early Redo Aortic Valve Replacement.

Early redo aortic valve replacement poses significant risks of pledget migration because of incomplete annular incorporation and suboptimal visualization. We describe a refined technique using a Foley catheter balloon, inflated within the left ventricular outflow tract, to create an atraumatic barrier during prosthesis explantation. In a patient presenting with severe paravalvular leak and hemolysis, this maneuver facilitated controlled valve removal and meticulous pledget retrieval without embolization. This reproducible approach enhances surgical safety in high-risk early reoperations, providing a reliable safeguard against debris migration during complex annular débridement.