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Eur J Cardiothorac Surg 2006;30:411
© 2006 Elsevier Science NL

Letter to the Editor

Are the aortic anatomical normal leaflets, normal leaflets?

Centro Cardiologico Monzino, IRCCS, Department of Cardiac Surgery, University of Milan, Via Parea 4, 20138 Milan, Italy

Received 14 March 2006; accepted 19 April 2006.

^_* Corresponding author. Tel.: +39 02 580021/355 563; fax: +39 02 580011194. (Email: luca.dainese{at}ccfm.it).

Key Words: Aortic root • Cardiac surgery • Innervation • Cardiac valves

I read with interest a recent article by Thubrikar et al. [1] where they suggest that in dilated aortic roots the anatomically normal leaflets, however, were not geometrically normal. Thus they conclude that during valve-sparing surgery, it may be necessary in some cases to correct not only the dilatation of the aortic root but also the leaflet free-edge length in order to achieve a competent valve.

We studied the nervous fibers distributions with glycosaminolglycans’ (GAG's) leaflet distribution in 15 aortic valve leaflets in aortic root dilated and judged anatomically normal and 15 leaflets in normal aortic valve (homograft). We found a significant decrease in the fibers innervation – acetylcholinesterase positive fibers – and also in GAG's total quantity and distribution [2,3].

The simple, anatomical, analysis of aortic leaflet before the surgery cannot be sufficient. As a matter of fact, this question is particularly relevant in case of plastic of aortic valve leaflets or valve-sparing procedures.

Footnotes

The authors of the original paper [1] were invited to comment on this Letter to the Editor but declined the offer.

References

1. Thubrikar MJ, Labrosse MR, Zehr KJ, Robicsek F, Gong GG, Fowler BL. Aortic root dilatation may alter the dimensions of the valve leaflets. Eur J Cardiothorac Surg 2005;28:850-856.[Abstract/Free Full Text]
2. Dainese L, Polvani GL, Barili F, Biglioli P. Aortic valve: do its nervous and contractile elements have any role?. Ital Heart J 2003;4(11):810-812.[Medline]
3. Dainese L, Barili F, Topkara VK, Cheema FH, Formato M, Guarino A, Micheli B, Biglioli P, Polvani GL. Effect of cryopreservation techniques on aortic valve glycosaminoglycans. Artif Organs 2006;30:259-264.[CrossRef][Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Luca Dainese Fabio Barili Gianluca Polvani Paolo Biglioli Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Dainese, L. Articles by Biglioli, P. Search for Related Content PubMed PubMed Citation Articles by Dainese, L. Articles by Biglioli, P. Related Collections Cardiac - physiology Cardiac - other Molecular biology Valve disease