Letter to the Editor Human aortic bioprosthesis

We have read with the greatest interest the paper by Wolfgang A. Goetz et al. entitled Truly stentless molded autologous pericardial aortic valve prosthesis with single point attached commissures in a sheep model [1]. We congratulate the authors on their achievements in the development of valve bioprosthesis. Apparently an autologous valve prosthesis is the subject of thorough study in the Medical University of Gdansk in cooperation with the Silesian Centre for Heart Diseases and with engineering support from the Ship Design and Research Centre in Gdansk. Therefore, we would like to comment on the above paper. The motivation for the autologous valve prosthesis we have developed and named HAB (human aortic bioprosthesis) has been quite similar to this emphasised by the authors. The idea of a valve bioprosthesis that is relatively inexpensive, reproducible, and has sufficient durability, as well as excellent haemodynamic parameters has existed in cardiovascular surgery for many years. However, there are certain differences among our solution i.e. HAB and SPAC (single point attached commissures) presented in the discussed paper. As well as making the prosthesis simple and based on mold design we have aimed to make it functionally as close as possible to the real valve. One of the essential issues arising from our clinical experience is the safety and the durability of the connection of the leaflets with the aortic wall. As the condition of the aorta wall may be substantially changed due to certain disease processes we have developed a T-shaped laps in the upper part of the leaflets. This solution allows for the connection of the leaflets with the aortawall, which reduces themaximum local stress in the aorta wall due to the increased number of connecting sutures. The risk of aorta wall fracture is addressed by the authorsof thediscussedpaper, nevertheless theyhavedecided to apply single point connection with patches located outside the aorta wall as the solution to the potential tearing