Month: August 2023

Polymers (Basel). 2023 Jun 23;15(13):2797. doi: 10.3390/polym15132797.

ABSTRACT

The meat industry generates a large amount of waste that can be used to create useful products such as bio-implants, which are usually expensive. In this report, we present an economic analysis of a continuous process for large-scale chemically cross-linked collagen scaffold (CCLCS) production in a Mexican context. For this purpose, three production capacities were simulated using SuperPro Designer^® v 12.0: 5, 15, and 25 × 10³ bovine pericardium units (BPU) per month as process feedstock. Data indicated that these capacities produced 2.5, 7.5, and 12.5 kg of biomesh per batch (per day), respectively. In addition, Net Unit Production Costs (NUPC) of 784.57, 458.94, and 388.26 $USD.kg^-1 were obtained, correspondingly, with selling prices of 0.16 ± 0.078 USD.cm^-2, 0.086 ± 0.043 USD.cm^-2, and 0.069 ± 0.035 USD.cm^-2, in the same order. We found that these selling prices were significantly lower than those in the current market in Mexico. Finally, distribution of costs associated with the process followed the order: raw materials > facility-dependent > labor > royalties > quality analysis/quality control (QA/QC) > utilities. The present study showed the feasibility of producing low-cost and highly profitable CCLCS with a relatively small investment. As a result, the circular bioeconomy may be stimulated.

PMID:37447444 | PMC:PMC10347289 | DOI:10.3390/polym15132797

Innovations (Phila). 2023 May-Jun;18(3):247-253. doi: 10.1177/15569845231173910. Epub 2023 May 24.

ABSTRACT

OBJECTIVE: Minimally invasive cardiac surgery has not been widely applied in repairing sinus venosus atrial septal defect (SV-ASD). Most were minithoracotomy using the single-patch technique for patients with anomalous pulmonary veins (APVs) connecting to the superior vena cava-right atrium (SVC-RA) junction. It is unclear whether patients with APVs draining high to the SVC can be repaired safely and effectively through port access.

METHODS: From May 2019 to October 2022, 11 consecutive SV-ASD patients with APVs connecting high to the SVC were enrolled in this prospective study. One 12 mm port and 2 trocars (5.5 mm and 10 mm) were established. The pleural and pericardial spaces were filled with CO₂. The SVC was snared just below the azygos vein. The RA incision was longitudinally extended along the SVC-RA junction to the SVC. The bovine pericardial patches were used to redirect the APV flow to the left atrium through the ASD and to enlarge the SVC and the SVC-RA junction.

RESULTS: There were no early or late deaths and no reoperations. The concomitant procedures included 5 patients (45.5%) with patent foramen ovale closure, 2 with ASD extension, and 3 with tricuspid valve repair. No endoscopic failure was recorded. The average cardiopulmonary bypass and operative times were 96 (23) min and 190 (30) min, respectively. No cases of venous stenosis or sinus node dysfunction were noted during follow-up of 16.4 ± 12.2 months.

CONCLUSIONS: SV-ASD with the APVs draining high to the SVC could be repaired safely and effectively through port access with a double-patch technique.

PMID:37222446 | DOI:10.1177/15569845231173910

Transl Pediatr. 2023 Apr 29;12(4):600-607. doi: 10.21037/tp-23-97. Epub 2023 Apr 26.

ABSTRACT

BACKGROUND: Pulmonary regurgitation following right ventricular outflow tract (RVOT) reconstruction may cause right heart dysfunction and even right heart failure. Installation of a single valve at this time point can effectively reduce pulmonary regurgitation, thereby protecting right heart function. Here, we analyzed the outcomes and mid- and long-term follow-up data of patients undergoing single-valved bovine pericardium patch (svBPP) placement for reconstruction and explored the effectiveness and gaps of svBPP in preventing right heart failure.

METHODS: A retrospective analysis was performed on patients undergoing RVOT reconstruction using BalMonocTM svBPP from October 2010 to August 2020. The follow up procedures included outpatient visits and collection of outcomes. The cardiac ultrasound-related indicators during the follow-up visits included ejection fraction (EF), right ventricular end-diastolic diameter (EDD), pulmonary regurgitation, and pulmonary artery stenosis. The survival rates and reoperation-free rate were analyzed by Kaplan-Meier method.

RESULTS: Patients includes tetralogy of Fallot, pulmonary atresia and other complex congenital heart disease. A total of 5 patients (5.7%) died during the perioperative period. Early complications included pleural effusion, cardiac insufficiency, respiratory insufficiency, chylothorax, and atelectasis, all of which were cured. After discharge, 83 patients (94.3%) were effectively followed up. During follow-up, 1 patient died and 1 patient underwent reoperation. The 1-, 5-, and 10-year survival rates were 98.8%, 98.8%, and 98.8%, respectively, and the reintervention-free rates for the same intervals were 98.8%, 98.8%, and 98.8%, respectively. The last follow-up ultrasound revealed severe pulmonary stenosis in 0 cases, moderate stenosis in 2 cases, mild stenosis in 7 cases, and no stenosis in 73 cases. Pulmonary regurgitation was not found in 12 patients; however, there were 2 cases of severe pulmonary regurgitation, 20 cases of moderate pulmonary regurgitation, and 48 cases of mild pulmonary regurgitation.

CONCLUSIONS: As shown in the mid- and long-term follow-up studies, BalMonocTM svBPP has good performance in RVOT reconstruction. It can effectively eliminate or reduce pulmonary valve regurgitation and protect right heart function. Both réparation à l’Etage ventriculaire (REV) and the modified Barbero-Marcial procedure can bring growth potential and reduce reoperation rate.

PMID:37181028 | PMC:PMC10167393 | DOI:10.21037/tp-23-97

Vasc Endovascular Surg. 2023 Jul 10:15385744231189021. doi: 10.1177/15385744231189021. Online ahead of print.

ABSTRACT

There is a paucity of research investigating revision surgery for patients with previous inferior vena cava (IVC) reconstruction using bovine pericardium (BP). To the best of our knowledge, no reports of redo procedures have been published in the medical literature. We describe two cases of redo surgery in patients with previous IVC reconstructions using BP following disease recurrence. The first case underwent resection of the BP graft with a second IVC reconstruction using BP, the second case underwent resection of the BP graft without reconstruction due to extensive thromboses. Neither case experienced perioperative complication or morbidity following their redo procedure, and previous IVC reconstruction with BP did not present significant intraoperative technical challenges. One case showed evidence of endothelialisation of the excised BP graft, however, it was not possible to definitively conclude if endothelialisation was present in the second case. Overall, these cases demonstrate that previous IVC reconstruction using BP should not be considered an absolute contraindication for redo surgery in the context of disease recurrence.

PMID:37427756 | DOI:10.1177/15385744231189021