Month: April 2026

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

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