Month: September 2025

Adv Mater. 2025 Aug 5:e2504765. doi: 10.1002/adma.202504765. Online ahead of print.

ABSTRACT

Cardiac patches to repair myocardial defects require mechanically stable materials that prevent bleeding and can be implanted via suturing. The current clinical standard, bovine pericardial patches (BPPs), serve this purpose but do not degrade or integrate with the myocardium, limiting their long-term effectiveness. Here, we present the reinforced cardiac tissue patch (RCPatch). This multimaterial patch comprises a stiffness-tuned, cardiomyocyte-infiltrated 3D metamaterial and a suturable, hydrogel-infiltrated mesh to reduce permeability and bleeding. Anisotropic metamaterials are designed and computationally optimized using a generative modeling approach and fabricated from poly(ε-caprolactone) (PCL) via volumetric 3D printing (VP). The metamaterial supports the infiltration of cardiomyocytes, which are viable and contract in vitro. The implantability and low blood permeability of the patch is enabled by adding a melt-electrowritten (MEW) mesh infiltrated with a fibrin hydrogel. In an acute large animal trial, the RCPatch was applied on an induced myocardial defect, where it withstood intraventricular blood pressure, prevented bleeding, and enabled hemodynamic restabilization (intraventricular pressure of 81 mmHg before, vs 66 mmHg after implantation). These findings establish a scalable framework for fabricating cardiac tissue patches that integrate mechanical reinforcement with biological function, offering a surgically implantable and future regenerative solution for intraventricular myocardial repair.

PMID:40761175 | DOI:10.1002/adma.202504765

Multimed Man Cardiothorac Surg. 2025 Sep 8;2025. doi: 10.1510/mmcts.2025.082.

ABSTRACT

The patient had rheumatic heart disease, which resulted in severe aortic and mitral valve regurgitation. Repair of both valves was performed at 9 years of age. During surgery, the retracted aortic valve cusps required extension with bovine pericardial patches and suture reduction annuloplasty, and the mitral valve was repaired using a Cosgrove-Edwards (Edwards Lifesciences LLC, Irvine, CA) annuloplasty band. Post-operative echocardiography showed no regurgitation in either valve. The patient is doing well at 2 years of follow-up.

PMID:40920352 | DOI:10.1510/mmcts.2025.082

Heart Rhythm. 2025 Jul 24:S1547-5271(25)02710-9. doi: 10.1016/j.hrthm.2025.07.029. Online ahead of print.

ABSTRACT

BACKGROUND: The transseptal approach for accessing left heart structures is commonly performed with metal needles and radiofrequency (RF) needles and wires, though how each device performs when crossing materials used in congenital heart disease (CHD) surgery is unknown.

OBJECTIVE: To compare the efficacy of commercially available transseptal devices in puncturing select materials relevant to CHD surgery.

METHODS: A custom-designed in vitro transseptal model was created. Transseptal devices included a metal needle, an RF needle, and an RF wire. Study materials included expanded polytetrafluoroethylene (ePTFE), polyester, and bovine pericardium; porcine atrial septum was the control material. The primary outcomes were (1) the number of 1-second RF pulses required to puncture for RF devices and (2) the peak force required to puncture for the metal needle.

RESULTS: Excluding ePTFE, RF-based devices punctured all materials at 5-10 g force with a single 1-second pulse. For ePTFE, the RF wire required a median of 4 seconds (range 2-6 seconds) of RF energy to puncture, whereas the RF needle failed entirely. The metal needle required higher forces across all materials, most drastically for polyester (median 277 g). The metal needle punctured ePTFE with reasonable force (median 68 g).

CONCLUSION: Commercially available RF transseptal platforms successfully puncture native septa, polyester, and bovine pericardium with short-duration RF energy delivered at low forces. Metal needles remain a cost-effective option when crossing native septum, ePTFE, and bovine pericardium. However, caution should be taken when puncturing polyester with the metal needle, given that substantially higher applied forces are required. The RF wire and metal needle are reasonable options for ePTFE puncture.

PMID:40714328 | DOI:10.1016/j.hrthm.2025.07.029