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J Thorac Cardiovasc Surg 1996;112:207
© 1996 Mosby, Inc.

LETTERS TO THE EDITOR

Aortic and aortic-mitral annular enlargement

Kaiser Platz 38C
Krefeld D-47800, Germany

To the Editor:

I want to clarify a number of items from Dr. D. Rastan's letter to the Editor published in the April 1995 issue of this Journal (1995;109:818-9). The following statements from his letter are not realistic: (1) "However, he decided to test it, led Dr. Manouguian in the design of experiments, applied the initial patches himself. . . ," (2) "Dr. Manouguian did not fail to work on that idea," (3) "did not perform a single operation," and (4) "led him to leave the university."

I proposed, supervised, and developed both surgical techniques in 1974 through 1976 at Göttingen University without any participation by Dr. H. Rastan. ^1,2 The research was accomplished with the support of the "Deutsche Forschungsgemeinschaft." Prof.Dr. J. Koncz, former director of the Department of Cardiovascular Surgery, confirmed my authorship of the two operative procedures.

These experiments were the basis for my thesis for assistant professor. ³ My thesis was accepted by the medical faculty and should be seen as proof of the scientific value of my work and of my personal integrity.

In 1974 I had already considered the possibility of patch enlargement of the aortic and mitral valve rings with aortic and mitral double valve replacement, and I conveyed this idea to Dr. D. Rastan himself. In my thesis I wrote that this method was independently conceptualized by Dr. H. Rastan and me. This statement was accepted by Dr. H. Rastan. The fact that Dr. H. Rastan is listed as coauthor of various publications does not imply his intellectual sponsorship.

I operated on the fifth patient to be treated by the first method. The first aortic and mitral double valve replacement with enlargement of both valve rings was done in January 1977 in Göttingen by P. G. Kirchhoff. ⁴

I left the clinic in 1979 for personal reasons, to prove myself as a vascular surgeon, but I am still a member of the medical faculty and I lecture regularly.

References

1. Manouguian S, Bock H, Kirchhoff PG. Erweiterungsplastik des Ausflußtraktes des linken Ventrikels. 5. Jahrestagung der Deutschen Gesellschaft für Thorax-, Herz- und Gefaßchirurgie. Bad Nauheim, February 1976.
   
2. Manouguian S. Erweiterungsplastik des hypoplastischen Aortenklappenringes. Beschreibung einer neuen Operationsmethode. Eine experimentelle Studie. Thoraxchirurgie 1976;24:418-23.
   
3. Manouguian S. Erweiterungsplastik des Aortenklappenringes. Beschreibung einer neuen Operationsmethode. Eine experimentelle Studie. Habilitationsschrift Göttingen, 1977.
   
4. Manouguian S, Kirchhoff PG. Patch enlargement of the aortic and mitral valve rings with aortic-mitral double valve replacement. Ann Thorac Surg 1980;30:396-9.[Abstract]
   

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