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Ann Thorac Surg 2007;83:1053-1054
© 2007 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Invited commentary

Thoralf Sundt, III, MD

Division of Cardiovascular Surgery, The Mayo Clinic, 200 First St, SW, Rochester, MN 55905

(Email: sundt.thoralf@mayo.edu).

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

A few years ago Francis Robicsek [1] asked "is it dead or alive?" regarding size reduction ascending aortoplasty. This article [2] is evidence that it is indeed alive, although debate continues as to whether or not it should be so. This argument has carried on for more than 3 decades. The obvious question is why?

I will begin by confessing my personal opinion, so that the reader can be wary of bias that may underlie my comments. I am opposed to it. I would argue that there is more to the risk of mechanical failure of the aorta than the Law of LaPlace (ie, the strength of the wall is as important an issue as wall tension) and reduction aortoplasty addresses only the latter. Laboratory investigations performed by ourselves and others have raised concerns regarding the composition, molecular biology, and material properties of the dilated aorta. My aversion for reduction aortoplasty is consonant with the majority view today, although this does not mean it is correct. There remains discussion within my own institution and among my colleagues regarding this matter, with some strong proponents of the technique.

. . . [Full Text of this Article]


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Unsupported Reduction Ascending Aortoplasty: Fate of Diameter and of Windkessel Function
Tobias Walker, Dorothee H.L. Bail, Miriam Gruler, Reinhard Vonthein, Volker Steger, and Gerhard Ziemer
Ann. Thorac. Surg. 2007 83: 1047-1053. [Abstract] [Full Text] [PDF]



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