Month: July 2025

Acta Biomater. 2025 Jun 1;199:90-107. doi: 10.1016/j.actbio.2025.04.054. Epub 2025 Apr 30.

ABSTRACT

The global aging population has led to an increasing prevalence of valvular heart disease (VHD), and the clinical application of bioprosthetic heart valves (BHVs) are growing with the advancement of transcatheter heart valve replacement surgery. However, BHVs, as xenogeneic pericardial tissue crosslinked with glutaraldehyde, have been affected by suboptimal cytocompatibility, thrombosis, immune response, and calcification, leading to premature degeneration and failure. Herein, a catechol-crosslinking strategy for BHVs was developed by conjugating porcine pericardia (PP) with catechols and subsequently coupling the grafted catechols to achieve the crosslinking and stabilization of BHVs. Caffeic acid and dopamine were exploited to conjugate the bioactive catechols on PP through amide condensation, and the catechols were further coupled under oxidation to impart the PP with enhanced stability and cytocompatibility as well as comparable mechanical properties to those of glutaraldehyde crosslinked PP (GLUT-PP). With the enrichment of catechols, the crosslinked PP not only demonstrated improved hydrophilicity to resist the blood components adhesion and thrombosis, but also enhanced the performance of endothelialization and antioxidation. Furthermore, the introduced catechols exhibits favorable anti-inflammatory properties, which significantly ameliorated the foreign body response and regulated the local immune responses of crosslinked PP. In conclusion, the catechol crosslinked PP is expected to be explored as a potential substitute for GLUT-PP to extend the lifespan of BHVs. STATEMENT OF SIGNIFICANCE: Bioprosthetic heart valves (BHVs) are mainly prepared from glutaraldehyde crosslinked porcine or bovine pericardia (GLUT-PP). Currently, BHVs are affected by cytotoxicity, thrombosis, calcification, and immunoinflammatory responses, which would accelerate degeneration and failure of BHVs. In this study, we developed a catechol crosslinking strategy for BHVs and engineered caffeic acid and dopamine-conjugated porcine pericardia (PP). In summary, catechol crosslinked porcine pericardia demonstrated enhanced collagen stability, antithrombosis, endothelialization, anticalcification and immunomodulation which reduced the risk of structural degeneration, suggesting that the catechol crosslinked porcine pericardia could serve as a potential alternative to GLUT-PP.

PMID:40316124 | DOI:10.1016/j.actbio.2025.04.054

Int J Surg Case Rep. 2025 Jun;131:111353. doi: 10.1016/j.ijscr.2025.111353. Epub 2025 Apr 23.

ABSTRACT

INTRODUCTION AND IMPORTANCE: Ectopia cordis is a rare congenital anomaly characterized by the abnormal positioning of the heart outside the thoracic cavity, frequently associated with additional congenital defects such as those seen in Pentalogy of Cantrell. Due to the rarity and severity of these anomalies, timely diagnosis and appropriate management remain clinically challenging but critical for patient outcomes.

CASE PRESENTATION: We report two distinct cases of ectopia cordis managed at our institution. The first case presented with complete ectopia cordis and absence of the sternum, requiring initial management with a Bogota bag followed by placement of bovine pericardium; unfortunately, the patient succumbed to complications of sepsis and heart failure at 12 days of life. The second case involved partial ectopia cordis accompanied by features of Pentalogy of Cantrell, managed conservatively with a Bogota bag and spontaneous epithelialization, resulting in successful discharge with stable clinical status.

CLINICAL DISCUSSION: Management of ectopia cordis, especially when complicated by associated anomalies, presents significant surgical and clinical challenges. Survival rates remain low due to complications such as sepsis, cardiac instability, and limited thoracic cavity space. Utilization of biomaterials like bovine pericardium has shown promise in providing necessary cardiac protection when primary closure is not feasible. Early multidisciplinary intervention, involving neonatologists, pediatric cardiologists, and surgeons, is crucial for optimizing outcomes.

CONCLUSION: While prognosis for ectopia cordis remains poor, careful and individualized management strategies, including timely intervention and infection prevention, can lead to favorable outcomes as demonstrated in our second case. This underscores the importance of a multidisciplinary approach and early prenatal diagnosis in enhancing survival rates for this rare condition.

PMID:40286694 | PMC:PMC12059706 | DOI:10.1016/j.ijscr.2025.111353