Surgical management of aplasia cutis congenita of the scalp and skull defect in a resource-limited setting: A case report

Surg Neurol Int. 2026 Jan 23;17:46. doi: 10.25259/SNI_1245_2025. eCollection 2026.

ABSTRACT

BACKGROUND: Aplasia cutis congenita (ACC) is a rare congenital condition marked by the absence of skin layers and sometimes underlying structures. Its etiology is unclear, with up to 70% of cases involving the scalp. We report the first document case of ACC in Ghana.

CASE DESCRIPTION: A 1-day-old female, born through spontaneous vaginal delivery after an uneventful pregnancy, was referred for management of a scalp defect noted at birth. Examination revealed an 8 × 5.5 cm central scalp defect with absent cranial vault, partial fronto-parietal bone loss, dural defect, exposed arachnoid membranes, and visible superior sagittal sinus. Other physical findings were normal. Brain magnetic resonance imaging (MRI), whole-body MRI, and echocardiography were unremarkable. A brain computed tomography confirmed a skull defect. The patient underwent a duraplasty using bovine pericardium and received serial wound dressings with epithelial growth factors. The defect reduced to 4.5 × 3.6 cm post-surgery and continues to improve pending potential cranioplasty at 2 years. ACC is primarily diagnosed clinically, and this patient was diagnosed with type 1 ACC. Management depends on subtype, location, defect size, and infection risk. In this case, surgery was employed due to the size of defect and the risk it posed. Prognosis is generally favorable, but limited resources may delay and increase complications in low-income settings.

CONCLUSION: ACC with skull and dural involvement poses serious risks to infant survival in resource-limited settings, where systemic challenges are pervasive. This case highlights the importance of care that is locally adapted, affordable, and delivered through strong multidisciplinary collaboration.

PMID:41660340 | PMC:PMC12875229 | DOI:10.25259/SNI_1245_2025

Effects of a Drying Treatment on the Mechanical Properties and Hemodynamic Characteristics of Bovine Pericardial Bioprosthetic Valves

J Funct Biomater. 2025 Nov 25;16(12):434. doi: 10.3390/jfb16120434.

ABSTRACT

The high incidence of cardiovascular disease and the early failure of bioprosthetic valves due to calcification have driven the development of anti-calcification technologies. As a new storage technology, drying treatment is expected to delay the calcification process by reducing glutaraldehyde residues. However, the effects of drying treatment on the mechanical properties and valve functions of bovine pericardial materials are still unclear. The objective of this study is to evaluate the influence of drying and rehydration treatments on the mechanical integrity and geometric properties of bovine pericardium and the hemodynamic performance of bioprosthetic valves made with these tissues. Cross-linked bovine pericardial samples (n = 15) were divided into three groups-wet (control group progressed with normal glutaraldehyde), dehydrated (ethanol-glycerol dehydration), and rehydration (saline immersion) groups-and the geometric stability and nonlinear mechanical behaviors of the materials were analyzed via thickness measurements and uniaxial and biaxial tensile tests. Quantitative results showed that thickness remained stable across groups (wet: 0.356 ± 0.052 mm; dry: 0.361 ± 0.053 mm; rehydrated: 0.361 ± 0.053 mm, p > 0.05). Elastic modulus values were preserved (wet: 12.5 ± 1.8 MPa; dry: 13.1 ± 2.0 MPa; rehydrated: 12.7 ± 1.9 MPa, p > 0.05), and anisotropy ratio showed no significant changes (1.53 ± 0.06 vs. 1.57 ± 0.07, p > 0.05). The hemodynamic performance of bioprosthetic valves made with these materials was evaluated in vitro using a pulsating flow simulation. Hemodynamic parameters demonstrated excellent preservation: effective orifice area (wet: 2.625 ± 0.11 cm2; rehydrated: 2.585 ± 0.12 cm2, Δ = 1.5%, p = 0.32) and regurgitation fraction (wet: 39.35 ± 2.9%; rehydrated: 42.78 ± 3.2%, p = 0.15) showed no statistically significant differences. The geometric properties of the material were not significantly changed by the drying treatment, and the material maintained its nonlinear viscoelastic characteristics and anisotropy. The rehydrated bioprosthetic valves did not differ significantly from those in the wet group in terms of the effective orifice area, regurgitation fraction, and transvalvular pressure difference, and the hemodynamic performance remained stable.

PMID:41440611 | PMC:PMC12734024 | DOI:10.3390/jfb16120434

Aortic pseudoaneurysm as a rare complication of purulent pericarditis: case report and literature review

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

Assessment of the stentless mitral valve and operation using bioengineering method

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

Stepwise Annular Reconstruction for Redo Double-Valve Surgery in Severe Mitral Annular Calcification

JACC Case Rep. 2026 Jan 14;31(2):106133. doi: 10.1016/j.jaccas.2025.106133. Epub 2025 Nov 22.

ABSTRACT

BACKGROUND: Redo aortic and mitral valve surgery with severe mitral annular calcification (MAC) and intervalvular fibrous body destruction is highly challenging; the Commando procedure is often a last resort.

CASE SUMMARY: A 59-year-old man with prior mechanical aortic and mitral valve replacements presented with hemolytic anemia due to a mitral paravalvular leak. Imaging showed severe MAC and tricuspid regurgitation. Intraoperatively, massive calcification and insufficient native tissue precluded standard anchoring for implantation of the new mechanical valves. In addition to the standard Commando procedure, a bovine pericardial patch was used reconstruct a neo-mitral annulus. Recovery was uneventful.

DISCUSSION: Bovine pericardial patches offer structural support when native tissue is inadequate, facilitating safe and durable outcomes in complex redo valve procedures.

TAKE-HOME MESSAGES: This case illustrates a viable surgical strategy for high-risk redo double-valve procedures. Bovine patch reconstruction enabled stable valve implantation and functional restoration in the setting of extensive MAC.

PMID:41273326 | DOI:10.1016/j.jaccas.2025.106133