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Normally, Letters-to-the-Editor are meant as commentaries by readers who want to share their thoughts on a recently published article in that same journal. They often make fascinating reading, not only in the daily news press, but also in the scientific literature. The way this journal handles Letters is to anonymize them and then send them to the authors of the original article with the offer of a reply to be published along with the letter. For obvious reasons both Letter and Reply should appear as closely as possible to the original article. A busy journal such as the New England Journal of Medicine (NEJM) has very strict rules for submission of Letters related to an article: “Letters in reference to a Journal article must not exceed 175words (excluding references), andmust be received within three weeks after publication of the article. Articles are available for selection on the submission site on the print publication date each Thursday and remain for three weeks.”1 When Andreas Boening approached Jeffrey Drazenwith a Letter-to-the-Editor after this deadline he was bound to fail at the unsurmountable walls of the submission system. No doubt he was late. Surgeons often are, with the typical excuse that they were too busy operating, admittedly a bad one. Nevertheless, the commentary, which had been discussedwith several colleagues (all busy operating) before submission, raises important points. In his disappointment Prof. Boening turned to Yours Truly, the Editor of the journal of his scientific society. After some deliberation I decided to accept the Letter for the following reasons: The original article will very probably belong to the most read andmost cited ones of the NEJM this year. It deals with a field where not only strictly medical issues are under discussion. The commentator comes from Germany, the uncrowned world champion in transcatheter valve implantation. The concerns raised are substantial and must be known to the public to enable a sound judgment of the setup of the study reported, its potential drawbacks, and to put its conclusions into perspective. So here it is: the Letter-to-the-Other-Editor. It may be a somewhat unusual construct, but in the interest of the fundamental right to freedom of expression and of open scientific discussion we have opened this door which must not be abused in the future. We’ll also make sure that Jeffrey Drazen will get his letter in the end.

Editor's Commentary: The Letter to the Other Editor