\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[ngerman,english]{babel}



\usepackage{float}








\begin{document}

\title{Reply to a brief comment on the past and present of surgical treatment
of cardiac wounds}



\author[1]{Erwan Flecher}%
\author[1]{Alain Leguerrier}%
\author[1]{Nicolas Nesseler}%
\affil[1]{University Rennes Hospital}%


\vspace{-1em}



  
  \date{May 19, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
Dear Editor, First we would like to thank Dr Lopez de la Cruz for her
comments and interest about our recently published article ``the odyssey
of suturing cardiac wounds: lessons from the past''. We highly
appreciated and agree with the complements she made especially about
Larrey and Milton role in this field. One should also note Theodore
Tuffier's attempt at cardiac resuscitation in 1898 in a young man dying
on the wards at La Piti\selectlanguage{ngerman}é Hospital (Paris)¹. Although this act was
performed on an unwounded heart it adds information about the history of
surgical approach in such dramatic condition. We do recognize left
anterolateral thoracotomy as the gold standard in an emergency room to
treat a penetrating cardiac injury. However a median longitudinal
sternotomy may be discussed in our opinion if the patient arrived
directly in a cardiac surgery operating theater. The patent presented in
our paper was directly brought in our operative theater of cardiac
surgery and managed immediately by cardiac surgeons and cardiac
anesthesiologists, with a cardiopulmonary bypass ready, dedicated scrub
nurses and perfusionist. In such specific conditions a sternotomy may be
discussed, depending on the context and the anatomical suspected lesions
(it was the option retained in the presented case and the surgical
procedure was safely performed with good outcome). Clearly, in a
peripheral hospital or at the emergency room sternotomy is not an option
to be considered and we agree with Dr Lopez de la Cruz.%
\end{abstract}\selectlanguage{ngerman}%



\sloppy


\textbf{Reply to a brief comment on the past and present of surgical
treatment of cardiac wounds}

\selectlanguage{ngerman}\emph{Erwan Flécher¹, Alain Leguerrier¹, Nicolas Nesseler².}

\textbf{Affiliations}

¹ Department of cardiothoracic and vascular surgery, University Rennes
Hospital, INSERM, LTSI - UMR 1099, F-35000 Rennes, France.

² Department of Anesthesia, University Rennes Hospital, Rennes, France

\emph{Corresponding author}\textbf{:}

Pr Erwan Flécher.

Service de chirurgie thoracique et cardio-vasculaire, CHU de Rennes, 2
rue Henri Le Guilloux, 35000 Rennes, France.

Tel: + 33 299 282 497, Fax: +33 299~282 496.

E-mail~:\emph{erwan.flecher@chu-rennes.fr}.

Dear Editor,

First we would like to thank Dr Lopez de la Cruz for her comments and
interest about our recently published article ``the odyssey of suturing
cardiac wounds: lessons from the past''.

We highly appreciated and agree with the complements she made especially
about Larrey and Milton role in this field. One should also note
Theodore Tuffier's attempt at cardiac resuscitation in 1898 in a young
man dying on the wards at La Pitié Hospital (Paris)¹. Although this act
was performed on an unwounded heart it adds information about the
history of surgical approach in such dramatic condition.

We do recognize left anterolateral thoracotomy as the gold standard in
an emergency room to treat a penetrating cardiac injury. However a
median longitudinal sternotomy may be discussed in our opinion if the
patient arrived directly in a cardiac surgery operating theater. The
patent presented in our paper was directly brought in our operative
theater of cardiac surgery and managed immediately by cardiac surgeons
and cardiac anesthesiologists, with a cardiopulmonary bypass ready,
dedicated scrub nurses and perfusionist. In such specific conditions a
sternotomy may be discussed, depending on the context and the anatomical
suspected lesions (it was the option retained in the presented case and
the surgical procedure was safely performed with good outcome). Clearly,
in a peripheral hospital or at the emergency room sternotomy is not an
option to be considered and we agree with Dr Lopez de la Cruz.

References

Anthony R. C. Dobell. Theodore Tuffier's attempt at cardiac
resuscitation. Ann Thorac Surg 1993;56:583-4.

\selectlanguage{english}
\FloatBarrier
\end{document}

