Abstract A handle holder is used in heart valve replacement surgery to insert a mechanical flow valve into the patient's heart. In order to position the valve correctly, a 0.1″ diameter titanium 6A1–4V handle holder shaft is bent until the proper angle is found. This bending of the tool makes it vulnerable to low-cycle fatigue failure. Low cycle fatigue testing of titanium 6A1–4V specimens shows that surface cracks appear approximately 20 cycles before failure occurs. It is recommended that the tool be carefully inspected before each use and replaced when surface cracks appear. The data showed that the life of the tool may be increased by 30% if it is bent in the same direction during its entire use. © 1998 Elsevier Science Ltd. All rights reserved.