| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2006;30:689-690
© 2006 Elsevier Science NL
Letters to the Editor |
a Cardiac Unit, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
b Experimentelle Thorax-, Herz und Gefäßchirurgie, Universitsät Münster, Münster, Germany
Received 9 May 2006; accepted 26 June 2006.
* Corresponding author. Tel.: +44 207 905 2295; fax: +44 207 905 2324. (Email: r.anderson{at}ich.ucl.ac.uk).
Key Words: Ventricular myocardium • Ventricular architecture • Cardiomyopathy
We read with considerable interest the extensive supplement that has recently appeared describing the features of the ‘helical heart’. As Buckberg [1] describes in his introduction, part of the purpose was to validate the anatomical findings supporting this concept, and as Buckberg [1] also explains, within the supplement is our own account which argues strongly against the concept of the ventricular myocardium being compartmented in such a way as to permit the uniform anatomical dissection of a ‘helical myocardial band’ [2]. We read with great care, therefore, the contents of the supplement to seek the anatomic validation for the compartmentation of the ventricular myocardium, since as we have pointed out previously [3], and as has been emphasised by other consummate cardiac anatomists [4], it is the presence of sheaths of fibrous tissue which permits anatomists to demonstrate the morphologic distinction of individual muscles, be they skeletal, smooth, or cardiac. We were surprised to find, therefore, that as far as we can establish, on only one occasion is the statement made that it is the arrangement of the fibrous matrix that permits distinction of the helical myocardial band [5]. We were even more surprised, however, then to note that Boineau [5], having made this crucial statement, fails to provide supporting anatomic evidence to substantiate this claim, nor does he reference the anatomic studies on which the claim is based. We presume that this must have been an oversight on the part of Boineau [5], and one that somehow went unnoticed by the Editor [1], since we hope that your readers will agree, in this era of evidence-based medicine, that such a claim cannot be made in the absence of substantiating evidence. This is the more important, since we have pointed out that, when the evidence is provided to demonstrate the fibrous structures that delineate the ‘helical myocardial band’, we are fully prepared to revise our own opinions. Until such time that the evidence is provided, however, we maintain our stance that the ventricular myocardium is not compartmented so as to permit uniform dissection to reveal a helical myocardial band extending from the pulmonary trunk to the aorta [2,3]. Since Boineau evidently now possesses this crucial information, could he be requested to share it?
References
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
