Women undergoing cardiac surgery have been historically recognized to carry higher periprocedural mortality risk. We aimed to investigate the influence of sex on clinical presentation, perioperative, and long-… Read More
Month: June 2024
Transcatheter mitral valve-in-valve for pregnancy with anti-phospholipid syndrome: a case report
Perioperative management and cardiac surgery in pregnant women with anti-phospholipid syndrome combined with heart valve disease have been rarely reported.
Double patch repair for complete atrioventricular septal defect using the Invengenx® patch
Complete congenital Atrio-Ventricular (AV) septal defect repair is a complex technique and can be performed as a single patch, modified single patch or a double patch technique. In addition, reconstructive surgeries make it more challenging as the native pericardium available for the repair is limited and of poor quality. Thus, the use of engineered bovine pericardium can help in the reconstruction of large AV canal defects. We used the Invengenx® patch for the repair of a complete AV canal defect and Pulmonary Artery (PA) plasty in a 20 month old female child with a previous PA banding. The patch had good flexibility, mechanical strength, suturability and there were no complications such as thrombosis or infection on follow up.
Reconstructive surgery in congenital cardiac anomalies is fraught with challenges due to surgical complexities and the limited availability of native pericardium for performing the repair of large defects. We used the Invengenx® bovine pericardial tissue patch for the repair of a complete AVSD (post-pulmonary artery banding) and found the patch to be suitable for the re-do procedure and noted uniform thickness, good flexibility, mechanical strength, suture retention and no infection or thrombosis.
Reconstruction of Fibrous Skeleton of the Heart for Double-Valve Replacement in A Pediatric Patient – Modified Commando Procedure
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2024;27:61-62. doi: 10.1053/j.pcsu.2024.01.006. Epub 2024 Jan 24.
ABSTRACT
The so-called Commando procedure, initially described by David and colleagues, consists in the reconstruction of the mitro-aortic fibrous lamina by a patch that enlarges both annuli. Its use has been described to upsize the aortic and mitral annulus for double valve replacement in adolescents. We describe a modified technique of this reconstruction of the fibrous skeleton of the heart, combined with Konno procedure to further enlarge the aortic annulus. In modified Commando procedure, following the reconstruction of aortomitral continuity with a bovine pericardium CardioCel patch (Admedus Regen Pty Ltd, Perth, WA, Australia), an aortic valved conduit that was made on the bench in order to have bottom skirt that enabled the suturing of the composite conduit far inside the left ventricle outflow tract. Coronary buttons were implanted at the supra-commissural level. The advantages of this modified Commando procedure are (1) the creation of a new aortic annulus when the integrity of this annulus has been compromised, (2) the upsizing of both annuli to any possible size of aortic and mitral prostheses, and (3) the relief of any residual left ventricular outflow tract obstruction.
PMID:38522874 | DOI:10.1053/j.pcsu.2024.01.006
Right ventricle pierced by a traditional sharp hair straightener: a case report
The case presents a traumatic ventricular perforation of a girl, accidentally felt on a sharp instrument. The uniqueness of the case presented is due to the very high infrequency of injuries with this type of … Read More
Efficacy of autologous blood patch injection for pneumothorax rate after CT-guided percutaneous transthoracic lung biopsy: a systematic review and meta-analysis
Pneumothorax is the most frequent complication after CT-guided percutaneous transthoracic lung biopsy (CT-PTLB). Many studies reported that injection of autologous blood patch (ABP) during biopsy needle withdr… Read More
Iatrogenic non-coronary leaflet perforation as a complication after robotic mitral valve repair
Iatrogenic aortic regurgitation secondary to leaflet injury is a rare complication of mitral valve surgery. For the first time, we report a patient who had progressive aortic regurgitation due to non-coronary … Read More
Co-occurrence of posterior chest wall pilonidal sinus with melanocytic nevus: a challenging presentation: a case report
To date, only a limited number of case reports have documented the co-occurrence of PNS and melanocytic nevus in the medical literature. This study aims to report an exceptionally rare case of posterior chest … Read More
Iatrogenic non-coronary leaflet perforation as a complication after robotic mitral valve repair
Iatrogenic aortic regurgitation secondary to leaflet injury is a rare complication of mitral valve surgery. For the first time, we report a patient who had progressive aortic regurgitation due to non-coronary … Read More
Tissue requirements for the application of aortic valve neocuspidization – appropriate pericardium properties and homogeneity?
J Mater Sci Mater Med. 2024 Apr 29;35(1):26. doi: 10.1007/s10856-024-06790-2.
ABSTRACT
OBJECTIVE: Aortic valve neocuspidization (AVNeo) using autologous pericardium is a promising technique. Expected advantages are reduced immune response, appropriate biomechanics and lower treatment expenses. Nevertheless, autologous pericardium can be affected by patient’s age and comorbidities. Usually, glutaraldehyde (GA) – fixed bovine pericardium is the basic material for aortic valve prostheses, easy available and carefully pre-examined in a standardized fabrication process. Aim of the study is the verification of autologous pericardial tissue homogeneity by analysing tissue thickness, biomechanics and extracellular matrix (ECM) composition.
METHODS: Segments of human GA-fixed pericardium selected by the surgeon based on visual criteria for cusp pre-cut and remaining after surgical AV replacement were investigated in comparison to bovine standard tissue treated equivalently. Pericardium sampling was performed at up to three positions of each sutured cusp for histological or biomechanical analysis, according to tissue availability.
RESULTS AND CONCLUSIONS: Human pericardia exhibited a higher heterogeneity in collagen content, density of vessel structures and elastic moduli. Thickness, vessel density and collagen and elastin content differed significantly between the species. In contrast, significant interindividual differences were detected in most properties investigated for human pericardial samples but only for tissue thickness in bovine tissues. Higher heterogeneity of human pericardium, differing vessel and collagen content compared to bovine state-of-the-art material might be detrimental for long term AV functionality or deterioration and have to be intensely investigated in patients follow up after autologous cusp replacement.
PMID:38683259 | PMC:PMC11058761 | DOI:10.1007/s10856-024-06790-2