Month: February 2026

Rev Col Bras Cir. 2026 Jan 23;52:e20253835. doi: 10.1590/0100-6991e-20253835-en. eCollection 2026.

ABSTRACT

INTRODUCTION: Surgical site infection (SSI) and polypropylene mesh (PPM) infections are recurrent problems in abdominal hernia surgeries, highlighting the need for a new antimicrobial material for surgical repair. The aim of this study was to evaluate the in vivo antimicrobial effect of a new biological mesh made of decellularized bovine pericardium (BP), added with vancomycin (VAN) or silver nanoparticles (AgNPs), as prevention for SSI.

METHODS: Thirty-five Wistar rats were divided into four groups: BP C+ (n=9) with BP without additions; PP C+ (n=8) with PPM; BP AgNPs (n=9) with BP added with silver nanoparticles; and BP VAN (n=9) with BP added with vancomycin. The 1 cm² meshes were stitched into the muscle fascia under the subcutaneous tissue of the rats’ backs, followed by inoculation with methicillin-resistant Staphylococcus aureus. The animals were observed for 7 days, with subsequent euthanasia, and histological and bacteriological analysis.

RESULTS: The BP VAN group had better infection control compared to the PP C+ and BP AgNPs groups (1×10¹ vs. 1.4×10³CFU/g, p=0.0303; 1×10¹ vs. 1.5x104CFU/g, p<0.0001, respectively). BP AgNPs showed less bacterial reduction compared to BP C+ (p=0.042). In the histological analysis, there was a mild inflammatory reaction in BP VAN, moderate in BP C+, and intense in PP C+ and BP AgNPs.

CONCLUSION: BP added with vancomycin showed promising antimicrobial action, while the use of silver nanoparticles did not demonstrate efficacy in this study.

PMID:41615166 | DOI:10.1590/0100-6991e-20253835-en

Medicine (Baltimore). 2026 Jan 16;105(3):e47074. doi: 10.1097/MD.0000000000047074.

ABSTRACT

Teflon felt (TFF) is widely adopted for microvascular decompression surgeries (MVDS) for hyperactivity syndrome involving the trigeminal neuralgia (TGN) and hemifacial spasm (HFS) while bovine pericardial patch (BPP) used for dural graft and not MVDS. We speculated that BPP roll around the nerve like an eggroll and fixed with a closing suture may solve the complications associated with TFF dependent MVDS and reduce hospital cost. We conducted a comparative retrospective study on all MVDS for TGN and HFS performed at the department of Neurosurgery, West China Hospital from January 1, 2015, to January 1, 2022. Data like clinical and imaging characteristics, operative procedures, postoperative complications, recurrence rate were recorded and compared between patients who underwent TFF and BPP MVDS. We observed a significant statistical difference (P = .0135) in recurrence and granuloma formation between the TFF and BPP MVDS. The time of recurrence and the annual rate of control of symptomatology were almost same in both groups until 30 months onwards where cases of recurrences were high in the TFF MVDS (4.2% vs 0%; P = .0135, 95% CI: 1.8-6.5%). Also, total cost was relatively lower in BPP MVDS compare to the TFF MVDS (P = .00135). BPP roll around the nerve like an eggroll and fixed with a closing suture could be a good alternative for TFF dependent MVDS. Notably, the BPP MVDS had no granuloma formation and no recurrence of symptomatology.

PMID:41560012 | PMC:PMC12826271 | DOI:10.1097/MD.0000000000047074

Gen Thorac Cardiovasc Surg. 2026 Jan 13. doi: 10.1007/s11748-025-02253-9. Online ahead of print.

ABSTRACT

OBJECTIVE: Pulmonary vein stenosis is a rare but serious complication following catheter ablation for atrial fibrillation. This study aimed to evaluate the mid-term outcomes of the sutureless marsupialization technique for acquired pulmonary vein stenosis or pulmonary vein occlusion.

METHODS: Between 2006 and 2024, six patients (mean age: 54.5 ± 9.0 years) with severe pulmonary vein stenosis or pulmonary vein occlusion after catheter ablation underwent surgical repair using the sutureless marsupialization technique. This approach avoids direct suturing to the pulmonary vein wall by covering the opened vein with autologous or xenogeneic tissue (left atrial appendage, pericardium, or atrial wall). A total of 13 pulmonary veins were reconstructed. Restenosis was evaluated using follow-up computed tomography, and 5-year patency was estimated by Kaplan-Meier analysis.

RESULTS: All patients underwent successful repair without perioperative complications. Covering materials included the left atrial appendage (n = 3), bovine pericardium (n = 2), autologous pericardium (n = 1), and atrial wall flap (n = 1). During a mean follow-up of 62.5 ± 46.5 months, restenosis occurred in 2 of 13 veins (15.4%) four months after surgery, both initially classified as stenotic lesions. All patients remained asymptomatic and required no further intervention. The 5-year patency rate was 84.6%.

CONCLUSIONS: The sutureless marsupialization technique offers good mid-term outcomes for acquired pulmonary vein stenosis and pulmonary vein occlusion after catheter ablation. By avoiding direct vein wall suturing, this approach may reduce restenosis. These results support its potential as a surgical option in selected patients with this rare complication.

PMID:41528589 | DOI:10.1007/s11748-025-02253-9

Ann R Coll Surg Engl. 2026 Jan 12. doi: 10.1308/rcsann.2025.0116. Online ahead of print.

ABSTRACT

INTRODUCTION: Infected aortic fields are among the most complex surgical challenges, often requiring urgent intervention and associated with a high risk of morbidity and mortality. Bovine pericardium offers a customisable, off-the-shelf option for in situ reconstruction using biological material. We evaluate long-term outcomes following emergency bovine pericardium neo-aorta reconstruction in infected aortic fields.

METHODS: Prospectively collected data for all patients treated with bovine pericardium neo-aorta reconstructions from 2018 to date were analysed. The surgical approach included resection of the infected aortic segment, explantation of previous grafts and/or stents, and reconstruction of the neo-aorta using a bovine pericardium sheet. Data collected included patient demographics, comorbidities, clinical presentation, previous interventions, blood tests, complications, length of antibiotic treatment and long-term survival. All neo-aortas were enrolled in an annual ultrasound surveillance programme to monitor for aneurysmal degeneration.

RESULTS: Fifteen aortic reconstructions were performed. The most common indication was aorto-enteric fistulas (n = 7), followed by infected aortic grafts (n = 4), mycotic aneurysms (n = 3) and one contaminated field due to emergency colectomy. Median follow-up was 34 months (range 9-84). Thirty-day mortality was 7%, with another 7% at 10 weeks. Antibiotic-free survival rate was 86%. One patient (7%) required long-term antibiotics post-partial endovascular aneurysm repair explant. Complications included one graft occlusion with limb loss and one case of end-stage renal failure. No aneurysmal degeneration was identified during follow-up.

CONCLUSION: Bovine pericardial neo-aorta reconstructions have shown excellent long-term resistance to infections and very good durability. Our data add to growing evidence supporting off-the-shelf use of bovine pericardium in emergency aortic reconstruction. Larger numbers through multicentre studies or special registries would help support more regular use.

PMID:41524123 | DOI:10.1308/rcsann.2025.0116

Ophthalmologie. 2026 Feb 17. doi: 10.1007/s00347-026-02398-9. Online ahead of print.

ABSTRACT

A 34-year-old male patient with primary juvenile open-angle glaucoma presented 3 months after trabeculectomy with mitomycin C in the left eye due to progressive visual deterioration. Ocular hypotension with an intraocular pressure of 2 mmHg was noted along with a prominent filtering bleb and macular folding of the retina and choroid as the cause of reduced visual acuity. The diagnosis of hypotony maculopathy was established. After an initial lack of improvement, revision surgery was performed. Intraoperatively, a very thin and undersized scleral flap with a torn suture as well as a disproportionately large sclerectomy were identified, rendering adequate suture revision impossible. Therefore, the fistulation site was covered with a 5 × 5 mm Lyoplant® implant (Aesculap, Braun, Melsungen, Germany, acellular bovine pericardium) and secured with sutures to achieve controlled reduction of aqueous humor filtration. The postoperative course was uneventful. The intraocular pressure normalized to 12 mmHg 6 weeks after revision surgery, visual acuity improved and optical coherence tomography demonstrated a normal macula. This case highlights the importance of adequate size and thickness of the scleral flap, particularly in young patients with more compliant sclera, to prevent hyperfiltration and hypotony maculopathy. Coverage of the scleral fistula with bovine pericardium proved to be an effective surgical treatment option.

PMID:41701367 | DOI:10.1007/s00347-026-02398-9

Ophthalmologie. 2026 Feb 17. doi: 10.1007/s00347-026-02398-9. Online ahead of print.

ABSTRACT

A 34-year-old male patient with primary juvenile open-angle glaucoma presented 3 months after trabeculectomy with mitomycin C in the left eye due to progressive visual deterioration. Ocular hypotension with an intraocular pressure of 2 mmHg was noted along with a prominent filtering bleb and macular folding of the retina and choroid as the cause of reduced visual acuity. The diagnosis of hypotony maculopathy was established. After an initial lack of improvement, revision surgery was performed. Intraoperatively, a very thin and undersized scleral flap with a torn suture as well as a disproportionately large sclerectomy were identified, rendering adequate suture revision impossible. Therefore, the fistulation site was covered with a 5 × 5 mm Lyoplant® implant (Aesculap, Braun, Melsungen, Germany, acellular bovine pericardium) and secured with sutures to achieve controlled reduction of aqueous humor filtration. The postoperative course was uneventful. The intraocular pressure normalized to 12 mmHg 6 weeks after revision surgery, visual acuity improved and optical coherence tomography demonstrated a normal macula. This case highlights the importance of adequate size and thickness of the scleral flap, particularly in young patients with more compliant sclera, to prevent hyperfiltration and hypotony maculopathy. Coverage of the scleral fistula with bovine pericardium proved to be an effective surgical treatment option.

PMID:41701367 | DOI:10.1007/s00347-026-02398-9

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

Ann Vasc Surg. 2025 Dec 31;125:196-205. doi: 10.1016/j.avsg.2025.12.030. Online ahead of print.

ABSTRACT

BACKGROUND: Biological grafts are the preferred option for in situ aortic reconstruction following infections, offering good survival and low complications rates. Vein harvesting may be challenging or undoable in emergency setting. Hence, xenogeneic materials, such as bovine grafts, gained popularity due to their availability, biocompatibility, and low reinfection rates despite data on their outcomes remain limited.

METHODS: A systematic review and metanalysis was conducted following Preferred Reporting Items for Systematic Reviews, and Meta-Analyses and Population, Intervention, and Outcome guidelines using PubMed, Scopus, and Web of Science. Two independent reviewers selected studies, extracted data, and assessed quality. A random-effects meta-analysis was done to evaluate survival, patency, and recurrence. Precision was assessed through 95% confidence intervals (CIs), and publication bias was examined using funnel plots and Egger’s test. The review was registered in International prospective register of systematic reviews (CRD42024629225).

RESULTS: Out of 96 papers screened, 15 studies (300 patients, 81.6% male, mean age 70.5 years) were included. The abdominal aorta was the most frequently treated segment (78.6%), followed by the descending thoracic (9%), thoracoabdominal aorta (6.3%), and ascending/arch (6%). Gram-positive bacteria were the most common pathogens (34.6%) encountered, followed by gram-negative (19%) and fungal infections (10%). Bovine pericardium in situ reconstruction was associated with a 30-day mortality rate of 19.8% (95% CI: 15.0%-25.7%), and an overall mortality of 30.5% (95% CI: 24.2%-37.6%). At a mean follow-up of 18.7 months, reinfection rate was 8.9% and patency rate 92.9%.

CONCLUSION: Bovine grafts show promising midterm results in treatment of aortic infections, assuring good survival and low recurrence rates at the midterm follow-up. Long-term data and comparative studies are needed to confirm their broader applicability.

PMID:41482178 | DOI:10.1016/j.avsg.2025.12.030

Rev Med Liege. 2025 Dec;80(12):770-775.

ABSTRACT

Prosthetic vascular infections are rare, occurring in less than 3 % of cases. If left untreated within the required timeframe, serious complications such septic shock and anastomotic rupture with hemorrhage may occur and lead to the patient’s death. Targeted and prolonged intravenous or oral antibiotic therapy is necessary but insufficient without surgical revision and removal of the infected prosthetic material. Once the infected prosthetic material is removed, blood continuity must be restored to ensure downstream vascularization and avoid amputation. There are two types of repair: extra-anatomical and in situ reconstructions. For the latter, it is ideal to avoid using prosthetic material. The solutions described in the literature are most often autologous venous grafts and cryopreserved arterial allografts. These are not always available. An alternative is to use a bovine pericardial patch, shaping it into a tube on the table with a longitudinal suture. We report a case of an infected common femoral artery prosthesis replaced with a pericardial patch and covered with the sartorius muscle.

PMID:41392629

Colloids Surf B Biointerfaces. 2026 Apr;260:115349. doi: 10.1016/j.colsurfb.2025.115349. Epub 2025 Dec 23.

ABSTRACT

Glutaraldehyde cross-linked bovine/porcine pericardium has been used as prosthetic heart valves (BHVs), while residual aldehyde groups induce cytotoxicity, thrombus formation, and progressive calcification deposition, which ultimately limits instrument life span to 10-15 years. We innovatively designed a multifunctional zwitterionic hydrogel coating copolymer poly (SBMA-co-DMEMAm) on swim bladder-derived material, which is composed of hydrophilic monomer SBMA and aldehyde-containing monomer DMEMAm; besides the aldehyde group can crosslink fish bladder tissue and improve the mechanical properties. This multifunctional hydrophilic polymer coatings provide effective anti-fouling properties, better anti-platelet adsorption and anti-thrombotic properties in in vitro blood compatibility evaluation. In addition, it showed better anti-inflammatory and anti-calcification properties in rat subcutaneous implantation. Thus, this study presents a versatile zwitterionic hydrogel coating strategy that simultaneously endows decellularized swim bladder with superior anti-fouling, hemocompatibility, cytocompatibility, and anti-thrombogenicity, offering a comprehensive solution for durable bioprosthetic heart valves.

PMID:41447863 | DOI:10.1016/j.colsurfb.2025.115349