Pre-Cardiopulmonary bypass, Mid-Esophageal Aortic Valve Short Axis View with Impella in place crossing the aortic valve between the non-coronary and right coronary cusps. On cardiopulmonary bypass following removal of Impella device, Mid-Esophageal Aortic Valve Short Axis with color flow doppler demonstrating 2 AI Jets, one central and one at the location of the removed Impella. On cardiopulmonary bypass following removal of Impella catheter, Mid-Esophageal Aortic Valve Long Axis view demonstrating the central aortic insufficiency jet. Post-cardiopulmonary bypass and aortic valve repair, Mid-Esophageal Aortic Valve Long Axis view demonstrating trace aortic insufficiency through a central jet.