Month: April 2026

ACS Biomater Sci Eng. 2026 Mar 9;12(3):1550-1564. doi: 10.1021/acsbiomaterials.5c01912. Epub 2026 Feb 19.

ABSTRACT

Subclinical leaflet thrombosis is a major cause of failure in both surgical and transcatheter bioprosthetic heart valves. Thromboresistance is a basic prerequisite for a cardiovascular biomaterial. In this study, bovine pericardium (BP) was decellularized and processed (DCL-BP) with 0.2% glutaraldehyde (GA) and covalently conjugated with amino acid derivatives. Hexylamides of L-Glutamic acid (Glutamyl dihexylamide-GHA), L-Lysine (Lysinyl hexylamide─LHA), and the propargyl derivative of L-Lysine (Lysinyl propargyl amide─K1 alk) were investigated. These modifications of BP generate three different scaffolds (DCL-GHA BP, DCL-LHA BP, and DCL-K1 alk BP) of varying surface energies and hydrophilic/phobic properties. The surface modifications altered the water contact angles of glutaraldehyde-processed pericardium from 59.25° to 67.74° in DCL-GHA BP and 79.98° in DCL-LHA BP, while DCL-K1 alk BP became highly hydrophilic such that the measurement of static angle was not feasible. Successful conjugations were confirmed by quenching of acid fuchsin color reaction and confocal Raman chemical mapping. The materials were found to be non-hemolytic and greatly reduced the overall protein adsorption and platelet adhesion, thus markedly improving the surface thromboresistance in vitro as observed by the whole blood clotting assay. The results of the ex vivo study in the sheep model correlated well with the in vitro data, where a marked reduction in protein adsorption from whole blood and platelet adhesion/thrombus deposition was observed, in comparison with the thrombogenic control. There was no activation of coagulation or complement system by any of the three test materials, making them non-thromboinflammatory and suitable candidate materials for use as a bioprosthetic heart valve leaflet.

PMID:41712900 | DOI:10.1021/acsbiomaterials.5c01912

BMJ Case Rep. 2026 Mar 25;19(3):e272043. doi: 10.1136/bcr-2026-272043.

ABSTRACT

We report the case of a man in his mid 70s with a history of coronary artery bypass grafting and prior surgical repair of an ascending aortic pseudoaneurysm using a bovine pericardial patch. He was subsequently found to have a persistent pseudoaneurysm adjacent to the right coronary ostium. In view of his prior sternotomy and the close proximity of the lesion to the coronary ostium, a transcatheter approach was selected. The pseudoaneurysm was successfully excluded using a duct occluder device, followed by deployment of a covered Papyrus coronary stent to reinforce the neck seal while preserving coronary flow. This case underscores the importance of multimodality imaging for diagnosis and procedural planning in complex, high-risk patients and demonstrates the feasibility of a dual-device transcatheter strategy for managing persistent aortic pseudoaneurysms in anatomically challenging locations.

PMID:41881477 | DOI:10.1136/bcr-2026-272043

North Clin Istanb. 2026 Feb 12;13(1):1-7. doi: 10.14744/nci.2026.39111. eCollection 2026.

ABSTRACT

OBJECTIVE: To assess the feasibility and early outcomes of single-stage hybrid revascularization consisting of common femoral endarterectomy with pericardial patch angioplasty and endovascular recanalization of the ipsilateral iliac arteries in patients with combined femoroiliac occlusive disease.

METHODS: Between January 2022 and October 2025, consecutive patients with multilevel iliofemoral peripheral artery disease (PAD) who underwent simultaneous single-stage hybrid revascularization at our institution were retrospectively analyzed. The hybrid strategy comprised common femoral endarterectomy with bovine pericardial patch angioplasty and intraoperative angiography-guided endovascular recanalization of the ipsilateral iliac arteries using balloon angioplasty with or without stent implantation; wire-guided iliac embolectomy was performed when indicated. Preoperative assessment included computed tomography angiography (1-mm slice thickness) and color-coded duplex ultrasonography. Patients were followed for at least three months with clinical assessment and duplex ultrasound. The primary endpoint was primary technical success of the planned hybrid procedure. Secondary endpoints included postoperative complications, length of hospital stay, three-month iliac stent patency, mortality, and amputation-free survival.

RESULTS: Twenty-eight patients were available for analysis. The median age was 73 (IQR: 14.5) years, and 64.3% were male. Most patients presented with advanced disease (Fontaine III-IV, 85.8%), and 60.7% had rest pain. Primary technical success was achieved in 85.7%. Bailout femorofemoral crossover bypass was required in 10.7%, and staged endovascular completion was planned in one patient. Iliac stenting was performed in 67.9%; wire-guided iliac embolectomy achieved thrombus extraction in 78.6% of attempted cases. The median length of stay was 10.5 (IQR:7) 13.4 days. Wound-healing disorders occurred in 7.1%. At three months, iliac stent patency was 100% and mortality was 0%. Amputation-free survival was 82.1%, with minor and major amputations in 10.7% and 7.1%, respectively.

CONCLUSION: Single-stage hybrid revascularization for femoroiliac occlusive disease in patients with advanced PAD was feasible and was associated with favorable early outcomes. Larger prospective studies with longer follow-up are needed to confirm durability and comparative effectiveness.

PMID:41940055 | PMC:PMC13047259 | DOI:10.14744/nci.2026.39111

Eur J Cardiothorac Surg. 2026 Mar 10;68(3):ezag097. doi: 10.1093/ejcts/ezag097.

ABSTRACT

OBJECTIVES: The availability and affordability of conduits have significantly challenged congenital heart surgery in low-resource settings. We present the intermediate-term outcomes of low-cost customized handmade conduits at our institution.

METHODS: Analysis of our surgical database and hospital information system (2016-2023) was done. Handmade conduits (cost: 30% of commercial conduits) were prepared in the operating room prior to surgery, using bovine pericardium for the conduit body tailored to the exact required diameter, with 0.1 mm polytetrafluoroethylene (PTFE) valve leaflets.

RESULTS: Handmade conduits were implanted in 185 patients [median age: 1.58 years (0.75-6.92), weight: 8.40 kg (6.30-17.03); conduit diameter 15 mm (13-20); cardiopulmonary bypass time 191.5 minutes (160-238) and cross-clamp time 106.5 minutes (73.8-145)]. Median ventilation duration was 19 hours (7-39), intensive care unit (ICU) stay 72 hours (44-120), and hospital stay 15 days (IQR: 11-20); mortality was 3.8%. The median follow-up duration was 29.5 months (14-59.5) for 160 patients. Peak conduit gradient on follow-up was 40 mm Hg (IQR: 22.8-63.8). Significant conduit regurgitation was noted in 21.2%. Endocarditis occurred in 7 (4.3%) patients (late in 4, early in 3). Re-interventions included 22 transcatheter procedures [18 balloon, 4 stents] at a median of 24 (12.2-34.7) months from conduit implantation. Of the 160 patients on follow-up, 28 had their conduits replaced at a median of 37 months (21-65 months) from implantation. Freedom from the composite end-point of reintervention/reoperation/death was 94% at 1 year; 70% at 5 years.

CONCLUSIONS: Handmade pericardial valved conduits are a potentially attractive low-cost alternative to commercially available conduits in low-resource settings.

PMID:41701157 | DOI:10.1093/ejcts/ezag097