HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map 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): Pasquale Totaro Vincenzo Argano Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Totaro, P. Articles by Argano, V. Search for Related Content PubMed Articles by Totaro, P. Articles by Argano, V. Related Collections Cardiac - other Valve disease

J Thorac Cardiovasc Surg 2008;135:465-466
© 2008 The American Association for Thoracic Surgery

Letter to the Editor

Reply to the Editor

^a Cardiac Surgery Division, Civic Hospital, Brescia, Italy
^b Department of Thoracic and Cardiovascular Surgery, Villa Maria Eleonora Hospital, Palermo, Italy

The first 20% of the full text of this article appears below.

We thank Pibarot and coauthors for their comments regarding our article.¹ It is surely a privilege that such distinguished colleagues take an interest in our study. Nevertheless, we found some of the comments inappropriate.

First, as far as the title was concerned, it was obviously provocative and was chosen just to underline an important matter related to this issue. As Pibarot and coauthors stressed in their comment, patient–prosthesis mismatch (PPM) is a hemodynamic phenomenon and therefore should be diagnosed on the basis of hemodynamic parameters related to a specific patient. This is the key point related to PPM after mitral valve replacement. In other words, to evaluate clearly the impact of PPM on functional and clinical outcomes, we have to be sure that we are comparing patients with PPM to patients without PPM.

As we clearly stated, this was the main objective of our study, which was indeed focused on the identification of patients with real PPM and on the evaluation of accuracy of prediction and diagnosis of PPM with data not obtained in vivo postoperatively and therefore not related to a specific patient.

In their comments, Pibarot and coauthors express serious concerns about the validity of our Doppler echocardiographic data, especially those related to effective orifice area (EOA). We would stress that the methodology we used (continuity equation method) was validated for assessing . . . [Full Text of this Article]