Reply to Tavlasoglu

We appreciate the remarks of Dr Tavlasoglu [1] concerning our experimental study dealing with off-pump transapical mitral valve replacement [2]. Dr Tavlasoglu is concerned about mitral valved stent fixation in the long-term follow-up. He explains the anatomy of the mitral annulus and refers to Carpentier who says that the mitral annular dilatation process is predominantly seen in the posterior annulus [3]. Dr Tavlasoglu hypothesizes that blood pressure and a movement of the heart during the cardiac cycle could lead to paravalvular leakage and stent dislocation. Our group has gained experience in transfemoral and transa-pical valved stent implantations with short- and long-term follow-ups for many years. We have not seen any late stent dis-location so far. In contrast, the exact positioning of the valved stents and early stent dislocation and movement are the pro