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Editor,We read with great interest the paper by Dinsmore et al., 1 and while we congratulate the authors for their original idea, anatomical model and working methodologies, we would like to express some concerns. References1 Dinsmore J, Heard AMB, Green RJ. The use of ultrasound to guide timecritical cannula tracheotomy when anterior neck airway anatomy is unidentifiable. 6 Stanbridge RDL, Hadjinikolaou LK. Technical adjuncts in beating heart surgery. Comparison of MIDCAB to off-pump sternotomy: a meta-analysis. Eur J Cardiothorac Surg 1999; 16 (suppl 2):S24-S33. 7 Lucchetti V, Capasso F, Caputo M, et al. Intracoronary shunt prevents left ventricular function impairment during beating heart coronary revascularization. Eur J Cardiothorac Surg 1999; 158:225-229. 8 Hangler HB, Pfaller K, Ruttmann E, et al. Effects of intracoronary shunts on coronary endothelial coating in the human beating heart.