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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 …
Competing interests The authors have no commercial interest in this device and received no remuneration of any kind in the development and evaluation of this device.
Provenance and peer review Not commissioned; internally peer reviewed.