Month: January 2026

JTCVS Tech. 2025 Sep 19;34:95-99. doi: 10.1016/j.xjtc.2025.08.027. eCollection 2025 Dec.

ABSTRACT

OBJECTIVE: We report the results of assessment of the Normo valve and the Normo operation using bioengineering methods.

METHODS: The Normo valve, made from bovine pericardium using a specially designed template and the flexible ring (27-mm Duran; Medtronic Inc), was installed into the pulsatile circulatory simulator. A 27-mm bioprosthetic valve (Mosaic; Medtronic Inc) was used as a control. The hydrodynamic performance of the Normo valve and bioprosthesis was investigated and compared. To assess the original template design, we created modified templates with slight alterations for both leaflets. The 4 types of valve made using these modified templates were tested to evaluate their hydrodynamic performance relative to the original design. In addition, finite element analysis was conducted to evaluate the relationship between leaflet stress and the distance between 2 major papillary muscles with the distances set at 18 mm, 24 mm, 30 mm, and 36 mm.

RESULTS: The waveforms of the Normo valve and bioprosthesis showed a similar pattern. As for the large leaflet, the Normo valve made from original design template revealed lowest pressure gradient compared to other 2 types. As for the small leaflet, the Normo valve made from original design template showed lowest pressure gradient with greatest forward flow. The stress on the leaflet increased for the distance between 2 papillary muscles at 18 mm and 36 mm.

CONCLUSIONS: The data obtained from the bioengineering method confirm the validity of the Normo valve’s design. Furthermore, the results show preferable positioning for the fixation of the leg to 2 papillary muscles.

PMID:41368376 | PMC:PMC12683050 | DOI:10.1016/j.xjtc.2025.08.027

Interdiscip Cardiovasc Thorac Surg. 2025 Nov 6;40(12):ivaf275. doi: 10.1093/icvts/ivaf275.

ABSTRACT

Root enlargement via traditional transverse or oblique aortotomy disrupts the anatomical features of smooth continuity and symmetry from the aortic root to the proximal ascending aorta. A straight longitudinal aortotomy, extended vertically into nadir of noncoronary aortic annulus, achieves smooth continuity and symmetrical enlargement from the aortic root to the proximal ascending aorta with a tear-drop-shaped bovine pericardial patch. Herein, we report successful symmetrical root enlargement following straight longitudinal aortotomy via right anterior minithoracotomy.

PMID:41270797 | PMC:PMC12668772 | DOI:10.1093/icvts/ivaf275

JACC Case Rep. 2026 Jan 28;31(4):106139. doi: 10.1016/j.jaccas.2025.106139.

ABSTRACT

BACKGROUND: Septic pseudoaneurysms of the native ascending aorta are rare and challenging to treat, especially in elderly, comorbid patients with septic conditions and unfavorable anatomy for endovascular repair.

CASE SUMMARY: A 78-year-old man with prior tricuspid valve replacement for endocarditis presented with methicillin-sensitive Staphylococcus aureus bacteremia. Imaging showed a large ascending aorta pseudoaneurysm, likely at the previous cardioplegia site. He underwent successful surgical repair via direct bovine pericardial patch closure under normothermic cardiopulmonary bypass. Recovery was uneventful.

DISCUSSION: Endovascular repair requires suitable anatomy, including adequate landing zones and small neck size, which were lacking here. Direct surgical patch repair offers a safe, effective, and less-invasive alternative to full aortic replacement, especially in septic, frail patients.

TAKE-HOME MESSAGES: Multidisciplinary heart team discussion is essential to tailor management for complex septic aortic pseudoaneurysms. When endovascular treatment is unfeasible, direct surgical patch repair remains a safe and effective option in selected patients.

PMID:41609270 | DOI:10.1016/j.jaccas.2025.106139

J Mater Sci Mater Med. 2025 Dec 9;37(1):2. doi: 10.1007/s10856-025-06970-8.

ABSTRACT

Combining decellularized biological scaffolds with PRP can prevent the rapid inactivation of growth factors and achieve their controlled and sustained release during tissue regeneration. Therefore, the purpose of this study was to evaluate the combined effect of decellularized bovine pericardium (dBP) and leukocyte-rich platelet-rich plasma (LR-PRP) on the bone repair in a rabbit femoral defect model. Bovine pericardium was decellularized using the Trypsin-Triton X-SDS protocol and histologically assessed. Unicortical bone defects were surgically created in the femur of rabbits (n = 6) and randomly assigned to three treatment allocations: (1) untreated control, (2) LR-PRP, and (3) LR-PRP + dBP-treated defects. Bone defect healing was evaluated using quantitative computed tomography (CT) and histopathological analyses. The dBP achieved 99.2% nucleus removal, retained about 34.3% of the sulfated glycosaminoglycan, and maintained a collagen content similar to the native pericardia. The CT voxel values of the defects treated with the LR-PRP + dBP increased by +33.2% and +56.2% at 2 and 4 weeks after surgery, respectively, compared to the control defects. As well, a significant rise in the CT values was observed in the LR-PRP + dBP treatment compared to the LR-PRP treatment alone at 2 weeks (p = 0.03) and 4 weeks (p = 0.02). Histopathologically, the LR-PRP + dBP treatment achieved higher bone repair scores with a significantly higher nascent bone area fraction (87.8%) compared to the LR-PRP (54%). These findings highlight the synergistic effect of dBP and LR-PRP, offering promising prospects in developing biocompatible scaffolds for enhancing bone repair.

PMID:41364201 | PMC:PMC12714762 | DOI:10.1007/s10856-025-06970-8

J Surg Case Rep. 2026 Jan 2;2026(1):rjaf1025. doi: 10.1093/jscr/rjaf1025. eCollection 2026 Jan.

ABSTRACT

We report a 70-year-old woman (body surface area 1.42 m²) undergoing redo double valve replacement with extensive annular enlargement using the Commando procedure. Thirteen years earlier, she received aortic valve replacement (St. Jude Medical 19 mm), mitral repair (Physio Ring 24 mm), and tricuspid annuloplasty. She presented with progressive heart failure; echocardiography showed severe mitral stenosis (mitral valve area 0.96 cm²) and moderate aortic stenosis with moderate paravalvular leak. To avert patient-prosthesis mismatch (PPM), both annuli were enlarged with bovine pericardium, permitting implantation of an Epic 27 mm mitral and an Inspiris 23 mm aortic bioprosthesis. Postoperative echocardiography demonstrated excellent hemodynamics (aortic effective orifice area 1.76 cm², mean gradient 6 mmHg; mitral mean gradient 3 mmHg). Recovery was uneventful, and she remains asymptomatic. Commando surgery enabled safe, simultaneous enlargement of both annuli, minimizing PPM, and preserving options for future valve-in-valve therapy.

PMID:41487892 | PMC:PMC12757946 | DOI:10.1093/jscr/rjaf1025

J Mater Sci Mater Med. 2025 Dec 9;37(1):2. doi: 10.1007/s10856-025-06970-8.

ABSTRACT

Combining decellularized biological scaffolds with PRP can prevent the rapid inactivation of growth factors and achieve their controlled and sustained release during tissue regeneration. Therefore, the purpose of this study was to evaluate the combined effect of decellularized bovine pericardium (dBP) and leukocyte-rich platelet-rich plasma (LR-PRP) on the bone repair in a rabbit femoral defect model. Bovine pericardium was decellularized using the Trypsin-Triton X-SDS protocol and histologically assessed. Unicortical bone defects were surgically created in the femur of rabbits (n = 6) and randomly assigned to three treatment allocations: (1) untreated control, (2) LR-PRP, and (3) LR-PRP + dBP-treated defects. Bone defect healing was evaluated using quantitative computed tomography (CT) and histopathological analyses. The dBP achieved 99.2% nucleus removal, retained about 34.3% of the sulfated glycosaminoglycan, and maintained a collagen content similar to the native pericardia. The CT voxel values of the defects treated with the LR-PRP + dBP increased by +33.2% and +56.2% at 2 and 4 weeks after surgery, respectively, compared to the control defects. As well, a significant rise in the CT values was observed in the LR-PRP + dBP treatment compared to the LR-PRP treatment alone at 2 weeks (p = 0.03) and 4 weeks (p = 0.02). Histopathologically, the LR-PRP + dBP treatment achieved higher bone repair scores with a significantly higher nascent bone area fraction (87.8%) compared to the LR-PRP (54%). These findings highlight the synergistic effect of dBP and LR-PRP, offering promising prospects in developing biocompatible scaffolds for enhancing bone repair.

PMID:41364201 | PMC:PMC12714762 | DOI:10.1007/s10856-025-06970-8

J Mater Sci Mater Med. 2025 Dec 9;37(1):2. doi: 10.1007/s10856-025-06970-8.

ABSTRACT

Combining decellularized biological scaffolds with PRP can prevent the rapid inactivation of growth factors and achieve their controlled and sustained release during tissue regeneration. Therefore, the purpose of this study was to evaluate the combined effect of decellularized bovine pericardium (dBP) and leukocyte-rich platelet-rich plasma (LR-PRP) on the bone repair in a rabbit femoral defect model. Bovine pericardium was decellularized using the Trypsin-Triton X-SDS protocol and histologically assessed. Unicortical bone defects were surgically created in the femur of rabbits (n = 6) and randomly assigned to three treatment allocations: (1) untreated control, (2) LR-PRP, and (3) LR-PRP + dBP-treated defects. Bone defect healing was evaluated using quantitative computed tomography (CT) and histopathological analyses. The dBP achieved 99.2% nucleus removal, retained about 34.3% of the sulfated glycosaminoglycan, and maintained a collagen content similar to the native pericardia. The CT voxel values of the defects treated with the LR-PRP + dBP increased by +33.2% and +56.2% at 2 and 4 weeks after surgery, respectively, compared to the control defects. As well, a significant rise in the CT values was observed in the LR-PRP + dBP treatment compared to the LR-PRP treatment alone at 2 weeks (p = 0.03) and 4 weeks (p = 0.02). Histopathologically, the LR-PRP + dBP treatment achieved higher bone repair scores with a significantly higher nascent bone area fraction (87.8%) compared to the LR-PRP (54%). These findings highlight the synergistic effect of dBP and LR-PRP, offering promising prospects in developing biocompatible scaffolds for enhancing bone repair.

PMID:41364201 | PMC:PMC12714762 | DOI:10.1007/s10856-025-06970-8

Acta Biomater. 2026 Jan;210:82-94. doi: 10.1016/j.actbio.2025.11.046. Epub 2025 Nov 26.

ABSTRACT

Aortic stenosis (AS) is characterised by the narrowing and stiffening of the aortic valve, which restricts blood flow from the heart to the rest of the body. Severe AS is a life-threatening condition which affects 1.48 % of individuals aged 55 and older, with a four-year mortality rate of 44.9 % if left untreated. Minimally invasive treatment for AS involves the implantation of a bioprosthetic valve with porcine or bovine pericardium leaflets, which frequently succumb to failure due to regurgitation or stenosis caused in part by calcification and structural damage. The relationship between these two durability-limiting processes is debated, and the influence of device crimping on both factors is not comprehensively understood. This study aims to explore the relationship between calcification and structural damage and determine if device crimping affects these processes. First, porcine pericardium (PP) tissue was exposed to either in vitro calcification in unloaded conditions (calcification) or cyclic bulge loading in saline, without calcification (structural damage). Subsequently, PP was simultaneously calcified and cyclically loaded for 30 million cycles. Simultaneous calcification and loading led to dramatically increased calcification and structural damage, including tissue rupture. Device crimping was not found to have a significant impact on calcification or structural damage. However, fibre architecture was found to affect rupture location, and dramatically affect the rate of rupture of PP. This finding has implications for future bioprosthetic valve leaflet anti-calcification strategies, where tissue mechanics influenced by the underlying tissue fibre architecture should be considered to minimise both structural damage and calcification. STATEMENT OF SIGNIFICANCE: Porcine pericardium (PP) is a commonly used biomaterial, most frequently in the leaflets of bioprosthetic valves. These devices frequently succumb to failure due to regurgitation or stenosis caused in part by calcification and structural damage of their leaflets. This work shows that calcification and structural damage work together to accelerate failure of PP, with dramatically increased calcification and structural damage of PP, including rupture, when the tissue is exposed to both simultaneously. Fibre architecture of PP was found to affect rupture location, and dramatically affect rate of rupture. This finding has implications for bioprosthetic leaflet durability, where tissue mechanics influenced by the underlying tissue fibre architecture should be considered to minimise both structural damage and calcification and maximise valve durability.

PMID:41314445 | DOI:10.1016/j.actbio.2025.11.046

Acta Biomater. 2025 Nov 26:S1742-7061(25)00882-7. doi: 10.1016/j.actbio.2025.11.046. Online ahead of print.

ABSTRACT

Aortic stenosis (AS) is characterised by the narrowing and stiffening of the aortic valve, which restricts blood flow from the heart to the rest of the body. Severe AS is a life-threatening condition which affects 1.48 % of individuals aged 55 and older, with a four-year mortality rate of 44.9 % if left untreated. Minimally invasive treatment for AS involves the implantation of a bioprosthetic valve with porcine or bovine pericardium leaflets, which frequently succumb to failure due to regurgitation or stenosis caused in part by calcification and structural damage. The relationship between these two durability-limiting processes is debated, and the influence of device crimping on both factors is not comprehensively understood. This study aims to explore the relationship between calcification and structural damage and determine if device crimping affects these processes. First, porcine pericardium (PP) tissue was exposed to either in vitro calcification in unloaded conditions (calcification) or cyclic bulge loading in saline, without calcification (structural damage). Subsequently, PP was simultaneously calcified and cyclically loaded for 30 million cycles. Simultaneous calcification and loading led to dramatically increased calcification and structural damage, including tissue rupture. Device crimping was not found to have a significant impact on calcification or structural damage. However, fibre architecture was found to affect rupture location, and dramatically affect the rate of rupture of PP. This finding has implications for future bioprosthetic valve leaflet anti-calcification strategies, where tissue mechanics influenced by the underlying tissue fibre architecture should be considered to minimise both structural damage and calcification. STATEMENT OF SIGNIFICANCE: Porcine pericardium (PP) is a commonly used biomaterial, most frequently in the leaflets of bioprosthetic valves. These devices frequently succumb to failure due to regurgitation or stenosis caused in part by calcification and structural damage of their leaflets. This work shows that calcification and structural damage work together to accelerate failure of PP, with dramatically increased calcification and structural damage of PP, including rupture, when the tissue is exposed to both simultaneously. Fibre architecture of PP was found to affect rupture location, and dramatically affect rate of rupture. This finding has implications for bioprosthetic leaflet durability, where tissue mechanics influenced by the underlying tissue fibre architecture should be considered to minimise both structural damage and calcification and maximise valve durability.

PMID:41314445 | DOI:10.1016/j.actbio.2025.11.046

BMC Cardiovasc Disord. 2025 Nov 24;25(1):830. doi: 10.1186/s12872-025-05332-0.

ABSTRACT

BACKGROUND: Purulent pericarditis has become rare in the antibiotic era, particularly when complicated by secondary infections such as an aortic pseudoaneurysm.

CASE PRESENTATION: We report a 46-year-old man who presented with persistent chest pain and cold sweats for three days. Imaging revealed a large pericardial effusion, and cultures grew methicillin-resistant Staphylococcus aureus(MRSA). The patient underwent partial pericardiectomy with delayed sternal closure and open irrigation. On day 23, he developed right shoulder pain, and imaging revealed a pseudoaneurysm of the ascending aorta. Thoracic endovascular aortic repair combined with bovine pericardial patch repair was performed. He survived and remained stable during a 13-month outpatient follow-up.

CONCLUSION: Given the potential for fatal outcomes, clinicians should maintain a high index of suspicion and initiate prompt management, despite the rarity of this complication.

PMID:41286644 | PMC:PMC12642142 | DOI:10.1186/s12872-025-05332-0