The penstyle handpiece was totally adapted to decalcify aortic valves quickly, with comfort and precision. Although the initial results of the ultrasound decalcification with the previous probes in aortic stenosis were impressive [4, 5] two principal problems were observed: early occurrence of aortic insufficiency and significant incidence of restenosis [2, 3]. Aortic insufficiency was caused by leaflet retraction and the loss of central coaptation thought to be secondary to the healing response [3]. The aortic restenosis was caused by the accumulation of calcium in the remaining fibrillar structure [6]. The excursion of our tip was 110 μm comparatively to the 154 μm excursion of the Cavitron® used by McBride [7]. As the Penstyle® handpiece decalcifies in better conditions than those previously described [8], with a lower level of mechanical energy, we expected a decreased healing response and consequently a decreased occurrence of aortic insufficiency. There is not any biological effects of our ultrasounds on the normal tissue, therefore we can use our probe safely in a therapeutic approach. The 1.54 mm end diameter of the Penstyle® was extremely precise to decalcify, rendering subsequent damaging of the normal valvular tissue around the calcium limited. The thin top of the probe allowed decalcification within the thickness of the leaflets without destroying the covering layers. The use of magnifying lenses facilitated an accurate procedure. This new approach of decalcification damages the valve as little as possible, so we hope to decrease the risk of early recalcification of the remaining valve. The ultimate test is the longevity of the improved flexibility and function in the patient, so we plan a clinical trial in patients to verify these two parameters. Lastly, we must distinguish two groups: calcific lumps on the aortic surface of the cusps favourable for ultrasound decalcification and embedded calcifications requiring an indispensable complementary treatment of the remaining cavities predisposing to early recalcification. The proposed indication for this new approach is a coronary bypass grafting associated with a stenosis of the aortic valve, when we hesitate to replace the valve. The expected advantage is to avoid a further operation to replace the aortic valve, with all the risks of a redo-operation.