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Has personalised surgery made another advancement in aortic root surgery?
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  • Published on:
    Response to “Has personalised surgery made another advancement in aortic root surgery?” by Zhu and Woo
    • Petr Nemec, Cardiac Surgeon Centre f Cardiovascular Surgery and Transplantation, Brno, Czech Republic
    • Other Contributors:
      • Petr Fila, Cardiac Surgeon

    We read with great interest the editorial of Zhu et al (1). The authors have great theoretical knowledge and experience in the treatment of aortic valve regurgitation. We agree with their conclusion concerning personalised external aortic root support (PEARS) that “there are still many questions to be answered”. We would like to try to answer some of them.
    Experience based on the first 100 operations in the Czech Republic (2) suggests that the indication for PEARS is limited to the patient with dilatation of the aortic root and/or ascending aorta and only trivial aortic regurgitation regardless of the origin of the disease. Implantation of PEARS should be considered as a preventive operation in group of patients that usually do not meet the criteria for valve sparing aortic valve replacement. In these patients the PEARS procedure can be performed as a measure to prevent further dilatation of the aorta and possible aortic dissection. The possibility of performing the operation without a cardiopulmonary bypass is certainly an advantage for the patient (2).
    The authors worried about wall tension after implantation. It is generally known, that decrease of the diameter which is achieved by PEARS implantation, reduces wall tension according to the La Place law. This procedure in fact decreases wall tension and moreover the wall of the aorta is externally supported.
    The fears about the viability of the aortic wall due to the continuous circumferential stress...

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    Conflict of Interest:
    None declared.