Ablation efficiency and residual thermal damage produced by pulsed holmium laser radiation were investigated in vitro for bovine mitral valves and human calcified and noncalcified cardiac valves. Low-OH quartz fibers (200 and 600 microns core diameter) were used in direct contact perpendicular to the specimen under saline or blood. Etch rate was measured with a linear motion transducer. Radiant exposure was varied from 0 to 3 kJ/cm2. For 200-microns fibers, the energy of ablation was approximately 5 kJ/cm3 in noncalcified and 15 kJ/cm3 in calcified valves. Etch rates were dependent on mechanical tissue properties. Maximum etch rate at 1,000 J/cm2 was 1-2 mm/pulse at 3 Hz repetition rate. Microscopic examination revealed a zone of thermal damage extending 300 microns lateral into adjacent tissue. Thermal damage was independent of radiant exposure beyond twice threshold.