Month: June 2026

Ann Thorac Surg Short Rep. 2025 Sep 1;4(1):102-107. doi: 10.1016/j.atssr.2025.08.010. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: Standardized bicuspid aortic valve (BAV) repair makes 2 symmetrical cusps by plicating the fused cusp, which is accompanied by risk of aortic stenosis. Here, the effect of improving cusp mobility by shortening the intercommissural distance (ICD) on increasing the aortic valve area was examined in a BAV model using a pulsatile flow simulator.

METHODS: Six pairs of symmetrical BAV were created in a neo-Valsalva graft with bovine pericardium (free margin length, 26 mm; geometric height, 20 mm), which were incorporated into a pulsation circuit simulator. The ICD was gradually shortened, and the forward flow, leakage flow, pressure gradient, and aortic valve area were measured. The average value of a total of 18 measurements (3 for each model) was examined.

RESULTS: Forward flow remained constant and leakage increased slightly with ICD shortening, but the differences were not statistically significant (P = .17). Peak and mean transvalvular pressure gradient were significantly reduced by ICD shortening (peak: control 26.75 ± 4.33 mm Hg vs 22-mm ICD 23.85 ± 2.91 mm Hg, P < .05; mean: control 17.57 ± 3.59 mmHg vs 20-mm ICD 14.76 ± 2.40 mm Hg, P = .01). Aortic valve area was increased significantly by ICD shortening (control 2.03 ± 0.37 cm² vs 18-mm ICD 2.71 ± 0.47 cm², P <.01).

CONCLUSIONS: With shortening of the ICD, the effect of increasing the aortic valve area and decreasing the pressure gradient was confirmed. Shortening the sinotubular junction diameter (= ICD) is important in aortic valvuloplasty for BAV.

PMID:42027503 | PMC:PMC13100733 | DOI:10.1016/j.atssr.2025.08.010

Ann Thorac Surg Short Rep. 2025 Sep 1;4(1):102-107. doi: 10.1016/j.atssr.2025.08.010. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: Standardized bicuspid aortic valve (BAV) repair makes 2 symmetrical cusps by plicating the fused cusp, which is accompanied by risk of aortic stenosis. Here, the effect of improving cusp mobility by shortening the intercommissural distance (ICD) on increasing the aortic valve area was examined in a BAV model using a pulsatile flow simulator.

METHODS: Six pairs of symmetrical BAV were created in a neo-Valsalva graft with bovine pericardium (free margin length, 26 mm; geometric height, 20 mm), which were incorporated into a pulsation circuit simulator. The ICD was gradually shortened, and the forward flow, leakage flow, pressure gradient, and aortic valve area were measured. The average value of a total of 18 measurements (3 for each model) was examined.

RESULTS: Forward flow remained constant and leakage increased slightly with ICD shortening, but the differences were not statistically significant (P = .17). Peak and mean transvalvular pressure gradient were significantly reduced by ICD shortening (peak: control 26.75 ± 4.33 mm Hg vs 22-mm ICD 23.85 ± 2.91 mm Hg, P < .05; mean: control 17.57 ± 3.59 mmHg vs 20-mm ICD 14.76 ± 2.40 mm Hg, P = .01). Aortic valve area was increased significantly by ICD shortening (control 2.03 ± 0.37 cm² vs 18-mm ICD 2.71 ± 0.47 cm², P <.01).

CONCLUSIONS: With shortening of the ICD, the effect of increasing the aortic valve area and decreasing the pressure gradient was confirmed. Shortening the sinotubular junction diameter (= ICD) is important in aortic valvuloplasty for BAV.

PMID:42027503 | PMC:PMC13100733 | DOI:10.1016/j.atssr.2025.08.010

Ann Thorac Surg Short Rep. 2025 Sep 1;4(1):102-107. doi: 10.1016/j.atssr.2025.08.010. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: Standardized bicuspid aortic valve (BAV) repair makes 2 symmetrical cusps by plicating the fused cusp, which is accompanied by risk of aortic stenosis. Here, the effect of improving cusp mobility by shortening the intercommissural distance (ICD) on increasing the aortic valve area was examined in a BAV model using a pulsatile flow simulator.

METHODS: Six pairs of symmetrical BAV were created in a neo-Valsalva graft with bovine pericardium (free margin length, 26 mm; geometric height, 20 mm), which were incorporated into a pulsation circuit simulator. The ICD was gradually shortened, and the forward flow, leakage flow, pressure gradient, and aortic valve area were measured. The average value of a total of 18 measurements (3 for each model) was examined.

RESULTS: Forward flow remained constant and leakage increased slightly with ICD shortening, but the differences were not statistically significant (P = .17). Peak and mean transvalvular pressure gradient were significantly reduced by ICD shortening (peak: control 26.75 ± 4.33 mm Hg vs 22-mm ICD 23.85 ± 2.91 mm Hg, P < .05; mean: control 17.57 ± 3.59 mmHg vs 20-mm ICD 14.76 ± 2.40 mm Hg, P = .01). Aortic valve area was increased significantly by ICD shortening (control 2.03 ± 0.37 cm² vs 18-mm ICD 2.71 ± 0.47 cm², P <.01).

CONCLUSIONS: With shortening of the ICD, the effect of increasing the aortic valve area and decreasing the pressure gradient was confirmed. Shortening the sinotubular junction diameter (= ICD) is important in aortic valvuloplasty for BAV.

PMID:42027503 | PMC:PMC13100733 | DOI:10.1016/j.atssr.2025.08.010

JTCVS Struct Endovasc. 2025 Mar 4;6:100048. doi: 10.1016/j.xjse.2025.100048. eCollection 2025 Jun.

NO ABSTRACT

PMID:42306055 | PMC:PMC13244763 | DOI:10.1016/j.xjse.2025.100048

Ann Thorac Surg Short Rep. 2025 Sep 1;4(1):102-107. doi: 10.1016/j.atssr.2025.08.010. eCollection 2026 Mar.

ABSTRACT

BACKGROUND: Standardized bicuspid aortic valve (BAV) repair makes 2 symmetrical cusps by plicating the fused cusp, which is accompanied by risk of aortic stenosis. Here, the effect of improving cusp mobility by shortening the intercommissural distance (ICD) on increasing the aortic valve area was examined in a BAV model using a pulsatile flow simulator.

METHODS: Six pairs of symmetrical BAV were created in a neo-Valsalva graft with bovine pericardium (free margin length, 26 mm; geometric height, 20 mm), which were incorporated into a pulsation circuit simulator. The ICD was gradually shortened, and the forward flow, leakage flow, pressure gradient, and aortic valve area were measured. The average value of a total of 18 measurements (3 for each model) was examined.

RESULTS: Forward flow remained constant and leakage increased slightly with ICD shortening, but the differences were not statistically significant (P = .17). Peak and mean transvalvular pressure gradient were significantly reduced by ICD shortening (peak: control 26.75 ± 4.33 mm Hg vs 22-mm ICD 23.85 ± 2.91 mm Hg, P < .05; mean: control 17.57 ± 3.59 mmHg vs 20-mm ICD 14.76 ± 2.40 mm Hg, P = .01). Aortic valve area was increased significantly by ICD shortening (control 2.03 ± 0.37 cm² vs 18-mm ICD 2.71 ± 0.47 cm², P <.01).

CONCLUSIONS: With shortening of the ICD, the effect of increasing the aortic valve area and decreasing the pressure gradient was confirmed. Shortening the sinotubular junction diameter (= ICD) is important in aortic valvuloplasty for BAV.

PMID:42027503 | PMC:PMC13100733 | DOI:10.1016/j.atssr.2025.08.010

Case Rep Med. 2026 Apr 20;2026:4459572. doi: 10.1155/carm/4459572. eCollection 2026.

ABSTRACT

Extracranial carotid artery aneurysms (ECAAs) are an increase of 50% or more in the diameter of the carotid artery and classified by location. They are rare and most are located in the internal carotid artery or carotid bifurcation. Diagnosis is incidental or by the presentation of a pulsatile neck mass or neurological symptoms. There are no universal recommendations regarding its treatment. Male, 72 years old, with a pulsatile cervical mass on the left. No history of previous trauma. Angioresonance and angiography identified a saccular aneurysm in the carotid bulb, measuring 1 × 0.7 cm. Referred for open surgical treatment, which was performed under general anesthesia and by longitudinal anterior cervicotomy, endoaneurysmorrhaphy, and bovine pericardium patch. There was an uneventful postoperative recovery and hospital discharge on the 3rd postoperative day. ECAAs represent between 0.4% and 1.9% of all peripheral aneurysms. They are more prevalent in men, with an average age at diagnosis of 53 ± 17 years. They can be divided into fusiform or saccular. The most common etiology of ECAA is atherosclerosis (50% of cases). ECAAs can be classified according to Attigah into Types I to V, based on the segment involved. Half of the patients with ECAAs have symptoms at diagnosis. Presentation may include a pulsatile neck mass, cervical discomfort, headache, stroke, or neurological deficits. Although rare, rupture can occur. The indication for correction of ECAAs is based on the risk of cerebral ischemia. Duplex ultrasound is the first option for diagnosis. Angiotomography, angioresonance, and angiography are options as confirmatory examinations. The techniques for repairing ECAAs are endovascular, hybrid or open: stents, embolization, or correction by arterial resection and reconstruction or patch. ECAAs are rare and have potential complications due to cerebral thromboembolism. ECAA repair is possible through open or endovascular techniques.

PMID:42023414 | PMC:PMC13095481 | DOI:10.1155/carm/4459572

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2026;29:24-31. doi: 10.1053/j.pcsu.2026.02.004. Epub 2026 Mar 2.

ABSTRACT

The criss-cross heart with double outlet right ventricle (DORV) and combined atrioventricular (AV) and ventriculoarterial (VA) discordance presents one of the most formidable challenges in congenital cardiac surgery. The unique ventricular topology and complex inflow-outflow relationships often preclude standard approaches to biventricular repair, and single-ventricle palliation is frequently selected. However, in appropriately selected patients, anatomical repair through a double switch procedure may offer superior long-term outcomes by preserving systemic ventricular function. This report describes a surgical strategy for addressing a criss-cross heart with DORV and AV/VA discordance using a modified Senning procedure as part of a double switch operation. Preoperative imaging-including transthoracic echocardiography, computed tomography angiography, and cardiac catheterization-is critical for assessing operability. Particular attention must be paid to pulmonary vascular resistance, Qp/Qs, morphologic left ventricular end-diastolic pressure, and coronary anatomy. The surgical technique involves ventricular septal defect baffle closure to direct left ventricular output to the pulmonary artery, an arterial switch operation, and a modified Senning atrial switch. The Senning component is performed using a pedicled autologous pericardial baffle augmented with a large bovine pericardial patch to prevent pulmonary venous pathway narrowing, a frequent concern in patients with criss-cross anatomy. This approach allows for biventricular repair even in cases with severe atrial and ventricular malalignment. The technique aims to achieve unobstructed systemic and pulmonary venous pathways, minimize arrhythmia risk, and establish long-term left ventricular systemic circulation. Careful patient selection and meticulous surgical execution are essential for optimizing outcomes in this complex subgroup of congenital heart disease.

PMID:42091300 | DOI:10.1053/j.pcsu.2026.02.004

J Biomater Sci Polym Ed. 2026 Apr 22:1-32. doi: 10.1080/09205063.2026.2659100. Online ahead of print.

ABSTRACT

Decellularized bovine and porcine pericardia are the most extensively used biological substitutes in clinical settings as self-regenerating replacements for treating cardiovascular anomalies. Despite advancements, these substitutes undergo early deterioration and degeneration if not crosslinked. The chemical crosslinking of these scaffolds, aimed at addressing their weak mechanical strength, hinders their long-term performance and regenerative efficacy. The present method describes the systematic evaluation of an alkaline-catalyzed, low-temperature mediated citric acid crosslinking strategy to incorporate silk fibroin (SF) for enhancing the biomechanical properties and stability of decellularized porcine pericardia (DPP) . Decellularization was performed using the tridecyl alcohol (ATE) method. Silk fibroin reinforced porcine pericardium (SFDPP) was systematically analyzed for successful incorporation of SF using histology, Confocal Raman microscopy, and SEM. Thermal analysis, biomechanical properties, suturability, and resistance to collagenase degradation has demonstrated increased strength and durability. In vitro cytocompatibility and toxicological studies further confirmed that SFDPP is biocompatible and non-toxic, making it suitable for cardiovascular applications. Rat subcutaneous implantation has proven SFDPP to be associated with significantly reduced inflammation and mineralization compared to the commercially available SJM Biocor pericardial patch. Results from rat abdominal wall defect and pig aortic vascular defect models demonstrated that SFDPP patch promoted structural restoration by site-appropriate constructive remodelling in both the defects. All these evidences confirmed its efficacy as a potential patch for treating cardiovascular defects.

PMID:42017470 | DOI:10.1080/09205063.2026.2659100

Acta Ophthalmol. 2026 Apr 16. doi: 10.1111/aos.70140. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the efficacy of tendon elongation using bovine pericardium (Tutopatch®) in complex strabismus surgeries, with a specific focus on longer follow-up of postoperative outcomes and patient satisfaction.

METHODS: In this pre-post cohort study, the records of all patients who underwent tendon elongation strabismus surgery with Tutopatch® at Radboudumc and Amsterdam UMC were retrospectively reviewed. Eligible patients were invited for a single prospective follow-up visit to assess long-term outcomes. Strabismus angle (success defined as ≤5.71° of orthotropia) and duction limitations (converted to a pseudo-quantitative scale ranging from 0 to 5) were evaluated preoperatively, 1 week postoperatively, 3 months postoperatively and at longer intervals where possible. Patient satisfaction was measured on a Visual Analogue Scale at the prospective follow-up.

RESULTS: Sixty-nine participants (mean age 41.3 ± 18.4 years) were included. Fifty-one patients had childhood onset and eighteen patients had acquired onset of strabismus. Tutopatch® was predominantly used to correct the horizontal deviation. Long-term follow-up data (>17.4 weeks) were available for 49 patients (71%), with a median follow-up of 124 weeks (range 19.9-431 weeks) and surgical success was achieved in 73% (near) and 60% (distance). Duction limitations significantly increased postoperatively, especially in exodeviations, but improved over time and seemed to have minimal impact on ocular alignment in primary position. Patient satisfaction was very high (median VAS 9.0), with only weak-to-moderate correlation with ocular alignment.

CONCLUSION: Tutopatch® is a viable surgical option for tendon elongation in complex strabismus cases with favorable long-term ocular alignment, mild duction limitation and high patient satisfaction.

PMID:41989268 | DOI:10.1111/aos.70140

Acta Ophthalmol. 2026 Apr 16. doi: 10.1111/aos.70140. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the efficacy of tendon elongation using bovine pericardium (Tutopatch®) in complex strabismus surgeries, with a specific focus on longer follow-up of postoperative outcomes and patient satisfaction.

METHODS: In this pre-post cohort study, the records of all patients who underwent tendon elongation strabismus surgery with Tutopatch® at Radboudumc and Amsterdam UMC were retrospectively reviewed. Eligible patients were invited for a single prospective follow-up visit to assess long-term outcomes. Strabismus angle (success defined as ≤5.71° of orthotropia) and duction limitations (converted to a pseudo-quantitative scale ranging from 0 to 5) were evaluated preoperatively, 1 week postoperatively, 3 months postoperatively and at longer intervals where possible. Patient satisfaction was measured on a Visual Analogue Scale at the prospective follow-up.

RESULTS: Sixty-nine participants (mean age 41.3 ± 18.4 years) were included. Fifty-one patients had childhood onset and eighteen patients had acquired onset of strabismus. Tutopatch® was predominantly used to correct the horizontal deviation. Long-term follow-up data (>17.4 weeks) were available for 49 patients (71%), with a median follow-up of 124 weeks (range 19.9-431 weeks) and surgical success was achieved in 73% (near) and 60% (distance). Duction limitations significantly increased postoperatively, especially in exodeviations, but improved over time and seemed to have minimal impact on ocular alignment in primary position. Patient satisfaction was very high (median VAS 9.0), with only weak-to-moderate correlation with ocular alignment.

CONCLUSION: Tutopatch® is a viable surgical option for tendon elongation in complex strabismus cases with favorable long-term ocular alignment, mild duction limitation and high patient satisfaction.

PMID:41989268 | DOI:10.1111/aos.70140