Can we consider thymectomy before pregnancy in female patients with myasthenia gravis?

Abstract

I read with interest a recent article by Thubrikar et al.[1] where they suggest that in dilated aortic roots theanatomically normal leaflets, however, were not geome-trically normal. Thus they conclude that during valve-sparing surgery, it may be necessary in some cases tocorrect not only the dilatation of the aortic root but alsothe leaflet free-edge length in order to achieve a competentvalve.We studied the nervous fibers distributions with glycosa-minolglycans’ (GAG’s) leaflet distribution in 15 aortic valveleafletsinaorticrootdilatedandjudgedanatomicallynormaland 15 leaflets in normal aortic valve (homograft). We founda significant decrease in the fibers innervation — acetylcho-linesterase positive fibers — and also in GAG’s total quantityand distribution [2,3].The simple, anatomical, analysis of aortic leaflet beforethe surgery cannot be sufficient. As a matter of fact, thisquestion is particularly relevant in case of plastic of aorticvalve leaflets or valve-sparing procedures.