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Eur J Cardiothorac Surg 2007;31:960-961. doi:10.1016/j.ejcts.2007.01.057
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved
Letters to the Editor |
a Cardiac Unit, Institute of Child Health, 30 Guilford St, London WC1N 1EH, UK
b Experimentelle Thorax-, Herz und Gefäßchirurgie, Universitsät Münster, Munster, Germany
Received 22 December 2006; received in revised form 22 December 2006; accepted 31 January 2007.
* Corresponding author. Tel.: +44 207 905 2295; fax: +44 207 905 2324. (Email: r.anderson{at}ich.ucl.ac.uk).
Key Words: Myocardium • Ventricular architecture • Three-dimensional arrangement
We note that, in their recent article published in the Journal, De Cicco and colleagues [1] cite our recent work [2] when they discuss the ‘tilting movement of the mitral valve annulus’. They go on to state, however, that our own work was ‘confirmed and revised’ by Torrent-Guasp and colleagues [3]. This is not true. The concept, as proposed by Torrent-Guasp and colleagues [3], is entirely foreign to our own findings [2]. Furthermore, in addition to the view advanced by Torrent-Guasp and colleagues concerning ventricular architecture being mutually incompatible with our own findings, it has never, as far as we are aware, been the subject of peer review, nor has it been substantiated by any independent anatomic investigation. Some of the initial dissections made by Torrent-Guasp [4] were comparable to our own findings. Dissections, however, are of necessity destructive. So as to confirm the three-dimensional arrangement of the myocytes making up the ventricular mass, it is necessary to validate dissections with histological studies and three-dimensional reconstructions. As far as we are aware, this was never done by Torrent-Guasp [4], nor by those who continue to espouse his concepts. Histological findings confirm the statement initially made by Pettigrew in 1908 [5], namely that the ventricular musculature has no beginning and no end, and is comparable in its structure at base and apex. Appreciation of this concept is now more important, since as shown by the experience of De Cicco and colleagues [1], it is becoming fashionable to promulgate surgical concepts on the basis of the spurious concepts put forward by Torrent-Guasp and colleagues [3]. Suffice it to say that there are no anatomical boundaries to be found within the ventricular walls that permit the distinction of a solitary continuous myocardial strip, as originally propounded by Torrent-Guasp and colleagues [3,4], let alone the dual pathways illustrated by De Cicco and colleagues [1] in their Fig. 2, which appeared on page 890 of the Journal.
References
This article has been cited by other articles:
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  G. De Cicco and R. Lorusso Reply to Anderson and Lunkenheimer: Tilting of the mitral valvar annulus Eur. J. Cardiothorac. Surg., May 1, 2007; 31(5): 961 - 961. [Full Text] [PDF]
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