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St. John's Mercy Medical Center, Department of Surgery, Suite R-7040, 625 South New Ballas Rd, St. Louis, MO 63141
(Email: ebsavage2{at}hotmail.com).
I recently read and was somewhat concerned by the title of an article in the "How to Do It" section in the July issue of The Annals of Thoracic Surgery, entitled "Z-Plasty Suture': A New Procedure for Complex Reconstructions of Posterior Mitral Leaflet" [1]. Although I find this technique very interesting, I want to point out that quite a few of us who have a large experience with mitral valve repair have been using this technique for years. I personally consider this an adaptation of a posterior folding plasty, which was referenced by Spencer and colleagues [2] in 1998, and an adaptation of the double-breasted mitral valve repair technique, which was described by Raman and colleagues [3] in 2002. Although I believe this is an excellent article and that it demonstrates the validity of this technique, I believe that this technique is not "new" and the authors should acknowledge the predecessors who proposed similar techniques that they have adapted and presented in this publication. Surgeons who perform mitral valve repair often understand that each case is different and requires creative adaptation of general principles to specific anatomy: a Z-plasty may be suitable when a simple posterior folding-plasty or double-breasted technique is not.
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R. Bellitti and P. Sante Reply. Ann. Thorac. Surg., June 1, 2008; 85(6): 2161 - 2161. [Full Text] [PDF] |
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