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Ann Thorac Surg 2007;83:354-355
© 2007 The Society of Thoracic Surgeons

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Correspondence

Reply

Department of Cardiovascular and Thoracic Surgery, Akashi Medical Center, 743-33 Okubo-cho Yagi, Akashi, 674-0063, Japan

(Email: kazu.y-akashi{at}amc1.jp).

To the Editor:

We would like to thank Drs Kadem and Garcia [1] for their letter regarding acquired von Willebrand disease with high shear stress aortic valve stenosis [2]. Recently several dynamic in vivo and in vitro studies have shown that anatomic asymmetry of the normal aortic root produces a dynamic deformation. Unfortunately, precise information on time-related changes in flow patterns at the aortic root is lacking (ie, the flow pattern of aortic root changes between rest and exercise). Therefore we used the formula (shear stress = 4 x blood viscocity x mean velocity/stenosis radius) reported by Gnasso and colleagues [3]. This equation is an approximate expression of shear stress at the aortic root, because an accurate equation of shear stress is not yet known.

We had not found the article regarding the energy loss index by Garcia and colleagues [4] when we wrote our article. In their excellent study, Garcia and colleagues [4] recently reported the energy loss index, which has the potential to indicate the severity of energy loss in aortic root downstream from a stenosed aortic valve. If we have an opportunity to report the correlation between patient-prosthesis mismatch and von Willebrand factor in the future, we will use their energy loss index measured by Doppler echocardiography. We thank Drs Kadem and Garcia [1] for their comment.

	References

Top References

 

1. Kadem L, Garcia D. Are we using the right fluid mechanics principles?(letter) Ann Thorac Surg 2007;83:354.[Free Full Text]
2. Yoshida K, Tobe S, Kawata M, Yamaguchi M. Acquired and reversible von Willebrand disease with high shear stress aortic valve stenosis Ann Thorac Surg 2006;81:490-494.[Abstract/Free Full Text]
3. Gnasso A, Carallo C, Irace C, et al. Association between intima-media thickness and wall shear stress in common carotid arteries in healthy male subjects Circulation 1996;94:3257-3262.[Abstract/Free Full Text]
4. Garcia D, Pibarot P, Dumesnil JG, Sakr F, Durand LG. Assessment of aortic valve stenosis severity: A new index based on the energy loss concept Circulation 2000;101:765-771.[Abstract/Free Full Text]

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 Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kazunori Yoshida Masahiro Yamaguchi Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Yoshida, K. Articles by Yamaguchi, M. Search for Related Content PubMed Articles by Yoshida, K. Articles by Yamaguchi, M. Related Collections Related Article