The author reflects on a study which assesses the efficacy of valve cutting and the degree of luminal damage done by four commonly used valvulotome. The author discussed the methods used by researchers in quantifying the instruments, including the re-usable LeMaire, expandable LeMaire, Gore Eze-Sit, and Mills, as well as the efficacy of the surgery. Findings and conclusions of the study were also presented. He suggested an alternative in case of incomplete valve analysis.