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Dear Editor, Valve replacing and valve-sparing root replacement were devised on the operating table and evolved by trial and error. Different times set different standards. By contrast, after 4 years of research collaboration between surgeons, anatomists and engineers (2000–2004), personalised external aortic root support (PEARS) has followed a standard protocol in 42 patients with over 170 patient-years of intention-to-treat analysis, and has been systematically and rigorously evaluated.
Cameron’s ‘two technical points’1 do not accurately reflect how this operation is in fact performed.2 The proximal …
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