LAUSR

J Card Surg. 2022;37:2713. wileyonlinelibrary.com/journal/jocs © 2022 Wiley Periodicals LLC. | 2713 Treatment of aortic stenosis has been evolving with the introduction of new technologies. Other than conventional aortic valve replacement (AVR) with or without a minimally invasive approach, there are two other treatment options, transcatheter aortic valve replacement (TAVR) and rapid deployment valve replacement (RDV). TAVR can be performed without a skin incision and does not require cardiopulmonary bypass. RDV requires cardiac arrest. However, applying stent technology for anchoring the valves only requires three sutures. Decalcification of calcified aortic annulus is one of the most important procedures during open surgery. It is needed in conventional AVR and RDV. However, the effect of decalcification on cardiac function after surgery is not well known. We read with great interest the article: “The effect of stent and decalcification on mitral annular motion after aortic valve replacement” by Daijiro Hori et al. The authors evaluated patients receiving Edwards (Edwards, Irvine, CA, USA) valves. Echocardiographic findings were compared among the three treatments postoperatively, at discharge and 1 year after the surgery. Mitral annular motion was evaluated by e prime, using tissue doppler imaging. And the authors in relation to the results concluded that although there was a significant improvement in pressure gradient and aortic valve area in patients receiving Inspiris, Intuity, and Sapien 3, significant improvement in e prime was observed only in patients receiving Inspiris. Multivariate analysis showed that the existence of a stent was an independent factor associated with changes in e prime after surgery. In this context, we congratulate the authors for this interesting study; this article has highlighted the aspect of the mitral annular motion on conventional AVR, TAVR, and RDV in relation to valve models and sizes. We think that continuous investigation of the aspect of mitral annular motion in relation to clinical outcomes and other new valve models and approaches in the future could be a crucial endpoint in the choice of surgical techniques, medical devices, and therapeutic direction.