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Ann Thorac Surg 2006;81:1585-1586
© 2006 The Society of Thoracic Surgeons

Original article: Cardiovascular

Invited commentary

Tirone E. David, MD

Toronto General Hospital, Room EN 13-219, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4

(Email: tirone.david@uhn.on.ca).

The first 20% of the full text of this article appears below.


   Introduction
 
In this article [1] the authors compared the outcomes of two techniques of implantation of aortic valve homograft for aortic valve replacement (AVR) (ie, aortic root replacement [RR] with aortic root preservation [RP]. They included the techniques of subcoronary implantation (with or without preservation of the noncoronary aortic sinus of the homograft) and aortic root inclusion under the same group. I do not know enough biostatistics to judge Grunkemeier's methodology for a meta-analysis on 11 nonrandomized clinical reports of such complex, varied, and heterogeneous patient population as AVR with aortic valve homograft. Most of those reports came from centers where the surgeons do not use aortic valve homograft routinely for AVR. Also important is the fact that the techniques of implantation of aortic valve homograft are highly variable among surgeons, and I question the appropriateness of including subcoronary implantation and aortic root inclusion into a same group. Actually, when implanted in appropriate patients using the correct technique, the aortic root inclusion is more like an . . . [Full Text of this Article]


Related Article

Homograft Implantation Techniques in the Aortic Position: To Preserve or Replace the Aortic Root?
Thanos Athanasiou, Catherine Jones, Ruyun Jin, Gary L. Grunkemeier, and Donald N. Ross
Ann. Thorac. Surg. 2006 81: 1578-1585. [Abstract] [Full Text] [PDF]





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