Month: July 2026

Pediatr Surg Int. 2026 May 19;42(1):236. doi: 10.1007/s00383-026-06441-3.

ABSTRACT

PURPOSE: We aimed to investigate whether pledget presence, pledget composition, and full versus partial thickness suture technique affect the force esophageal tissue can withstand before tearing.

METHODS: A right thoracotomy was performed on 10 deceased fetal sheep, 110-114 days gestation. The esophagus was divided at the level of the carina and 2 cm of tissue was removed to mimic long-gap esophageal atresia. The pouches were sutured with horizontal mattress non-absorbable braided polyester suture using one of three methods: polytetrafluoroethylene (PTFE) pledgets, bovine pericardial pledgets, or no pledget, in full or partial thickness manner. Each suture was attached to a tensiometer and manually tightened at 50 gram-force / 30 s. Maximal force before esophageal tearing and time to tearing were measured. Results were compared using a linear mixed model.

RESULTS: PTFE pledgets withstood significantly more force than pericardial pledgets (p = 0.029) and provided longer duration before tearing compared to no pledget (p = 0.017) and pericardial pledgets (p = 0.047). Full versus partial-thickness technique made no difference.

CONCLUSION: In a deceased fetal lamb long-gap esophageal atresia model, PTFE pledgets improved tissue resistance to tearing (PTFE > pericardial) and prolonged stretch duration (PTFE > pericardial or no pledget). Suture thickness (full vs. partial) made no difference.

PMID:42154275 | DOI:10.1007/s00383-026-06441-3

Int J Biol Macromol. 2026 Jun;367:152551. doi: 10.1016/j.ijbiomac.2026.152551. Epub 2026 May 14.

ABSTRACT

The longevity and applicability of glutaraldehyde cross-linked commercial bioprosthetic heart valves (BHVs) that are the first choice for the transcatheter heart valve replacement (THVR) remain limited due to thrombus accumulation, calcification, inflammatory reactions and poor endothelialization. In this study, we first performed the prefunctionalization treatment of dual crosslinking by carboxymethylated λ-carrageenan and 4-pentenoic acid on decellularized bovine pericardium; subsequently, we conducted a post-functionalization treatment by dual modification of immobilizing the cyclodextrin (CD)/rutin and organic selenium onto above-mentioned doubly cross-linked (DC) bovine pericardium through the amidation reaction; finally, we obtained the anticipated bioprosthetic heart valve with multiple functions (DC + CD/Rutin+Se-BP). Uniaxial tensile tests demonstrated that this doubly cross-linked BHV exhibited superior mechanical properties compared with glutaraldehyde-treated bovine pericardium, which is expected to increase its structural stability and service life. By introducing the CD/Rutin complex and organic selenium, DC + CD/Rutin+Se-BP not only exhibited the ability to inhibit the adsorption of plasma proteins, platelet aggregation and thrombosis but also presented the excellent anti-inflammatory and anti-calcification characteristics both in vitro and in vivo. Furthermore, DC + CD/Rutin+Se-BP also exhibited stable in situ nitric oxide (NO) catalytic release ability due to the immobilization of organic selenium, which endowed bioprosthetic heart valve with excellent compatibility with human umbilical vein endothelial cells (HUVECs) and facilitated the long-term promotion of its endothelialization process. In summary, this approach combining dual cross-linking and dual modification provides a promising strategy for future design of BHVs, and DC + CD/Rutin+Se-BP exhibits a bright prospect in the clinical applications of BHVs.

PMID:42140293 | DOI:10.1016/j.ijbiomac.2026.152551

Multimed Man Cardiothorac Surg. 2026 May 19;2026. doi: 10.1510/mmcts.2026.008.

ABSTRACT

Surgery for radiation-associated valve disease is technically demanding due to challenging exposure, extensive calcification, and risk of paravalvular leak or atrioventricular groove disruption. An oblique aortotomy revealed heavy calcification extending to the aortomitral continuity, where only a 23 mm sizer could barely pass. The aortotomy was extended into the non-coronary sinus adjacent to the left-non commissure. An extended transseptal approach was employed and connected to the aortotomy. The anterior mitral leaflet was excised. From trigone to trigone, non-everting buttressed stitches were placed in the posterior annulus to avoid the mitral annular calcification. A 2-cm-wide felt strip collar, corresponding to the mitral annular calcification depth, was secured to a 31 mm mitral bioprosthesis with running polypropylene sutures. The valve stitches were passed through the felt strip, and after tying them down, a folded bovine pericardial patch was sewn to the anterior annulus of the mitral prosthesis using a running suture. One side of the patch was used to close the dome of the left atrium; the other side was used to close the aortotomy. A 27 mm aortic prosthesis was then easily implanted due to root enlargement. The aortotomy was closed, and the patient was weaned from cardiopulmonary bypass without difficulty.

PMID:42153558 | DOI:10.1510/mmcts.2026.008

Int Braz J Urol. 2026 Sep-Oct;52(5):e20269906. doi: 10.1590/S1677-5538.IBJU.2026.9906.

ABSTRACT

OBJECTIVE: Penile urethral stricture is a potential complication after any form of urethral instrumentation. Treatment options may be limited when considering direct urethrotomies or urethroplasties without grafting, due to the increased risk of penile shortening and functional compromise. In this context, among the various graft materials described in the literature (including buccal mucosa, lingual mucosa, bladder mucosa, colonic mucosa, augmentation urethroplasty with skin flaps, and injectable antifibrotic agents) (1, 2) the use of bovine pericardium appears promising (3). In this video, we present a clinical case in which the L-Hydro® tissue treatment technology 100% aldehyde free, VIVENDI™ graft was used as a graft for the surgical repair of penile urethral stricture following radical prostatectomy.

MATERIALS AND METHODS: The present study was approved by the hospital’s Institutional Ethics Committee in accordance with ethical standards for research involving human subjects. A 65-year-old male patient developed a penile urethral stricture following urethral instrumentation and prolonged urinary catheter use after radical prostatectomy. Preoperative evaluation included cystourethrography, which demonstrated a 1.2 cm stricture in the penile urethra. Urethroplasty was indicated for definitive surgical management. Under regional anesthesia, a longitudinal penile incision was made, followed by a ventral sagittal urethrotomy directly over the stricture segment. A free aldehyde-free bovine pericardium graft (VIVENDI™) was tailored to the defect and placed as a dorsal onlay within the urethrotomy. The graft was secured with interrupted 4-0 poliglecaprone 25 sutures. The ventral urethrotomy was closed over a 16 Fr silicone Foley catheter, and the penile incision was closed in layers. Follow-up assessments included uroflowmetry and post-void residual urine measurement at 4 weeks, with urethroscopy performed at 7 weeks postoperatively to evaluate urethral patency and graft integration.

RESULTS: No intraoperative or postoperative complications occurred. Seven weeks after surgery, the patient underwent urethroscopy, which demonstrated a well‑appearing urethral lumen without evidence of stricture or signs of infection. The graft was observed to be well incorporated into the urethral wall with no adverse tissue reaction. At follow‑up, the patient also demonstrated adequate bladder emptying, with satisfactory voiding parameters and low post‑void residual urine.

CONCLUSIONS: In this reported case, the use of a bovine pericardium graft demonstrated satisfactory results in penile urethroplasty for the treatment of a urethral stricture. Based on current evidence, bovine pericardium appears to be a feasible graft option for complex urethral reconstruction. However, further studies involving larger patient cohorts and multicenter collaboration are necessary to confirm these findings and better define the long‑term efficacy and safety of this approach.

PMID:42133856 | DOI:10.1590/S1677-5538.IBJU.2026.9906

Int Braz J Urol. 2026 Sep-Oct;52(5):e20269906. doi: 10.1590/S1677-5538.IBJU.2026.9906.

ABSTRACT

OBJECTIVE: Penile urethral stricture is a potential complication after any form of urethral instrumentation. Treatment options may be limited when considering direct urethrotomies or urethroplasties without grafting, due to the increased risk of penile shortening and functional compromise. In this context, among the various graft materials described in the literature (including buccal mucosa, lingual mucosa, bladder mucosa, colonic mucosa, augmentation urethroplasty with skin flaps, and injectable antifibrotic agents) (1, 2) the use of bovine pericardium appears promising (3). In this video, we present a clinical case in which the L-Hydro® tissue treatment technology 100% aldehyde free, VIVENDI™ graft was used as a graft for the surgical repair of penile urethral stricture following radical prostatectomy.

MATERIALS AND METHODS: The present study was approved by the hospital’s Institutional Ethics Committee in accordance with ethical standards for research involving human subjects. A 65-year-old male patient developed a penile urethral stricture following urethral instrumentation and prolonged urinary catheter use after radical prostatectomy. Preoperative evaluation included cystourethrography, which demonstrated a 1.2 cm stricture in the penile urethra. Urethroplasty was indicated for definitive surgical management. Under regional anesthesia, a longitudinal penile incision was made, followed by a ventral sagittal urethrotomy directly over the stricture segment. A free aldehyde-free bovine pericardium graft (VIVENDI™) was tailored to the defect and placed as a dorsal onlay within the urethrotomy. The graft was secured with interrupted 4-0 poliglecaprone 25 sutures. The ventral urethrotomy was closed over a 16 Fr silicone Foley catheter, and the penile incision was closed in layers. Follow-up assessments included uroflowmetry and post-void residual urine measurement at 4 weeks, with urethroscopy performed at 7 weeks postoperatively to evaluate urethral patency and graft integration.

RESULTS: No intraoperative or postoperative complications occurred. Seven weeks after surgery, the patient underwent urethroscopy, which demonstrated a well‑appearing urethral lumen without evidence of stricture or signs of infection. The graft was observed to be well incorporated into the urethral wall with no adverse tissue reaction. At follow‑up, the patient also demonstrated adequate bladder emptying, with satisfactory voiding parameters and low post‑void residual urine.

CONCLUSIONS: In this reported case, the use of a bovine pericardium graft demonstrated satisfactory results in penile urethroplasty for the treatment of a urethral stricture. Based on current evidence, bovine pericardium appears to be a feasible graft option for complex urethral reconstruction. However, further studies involving larger patient cohorts and multicenter collaboration are necessary to confirm these findings and better define the long‑term efficacy and safety of this approach.

PMID:42133856 | DOI:10.1590/S1677-5538.IBJU.2026.9906