Month: September 2026

Clin Transplant. 2026 Aug;40(8):e70658. doi: 10.1111/ctr.70658.

NO ABSTRACT

PMID:42611543 | PMC:PMC13484882 | DOI:10.1111/ctr.70658

J Funct Biomater. 2026 Jul 28;17(8):362. doi: 10.3390/jfb17080362.

ABSTRACT

Background: Energy dissipation reflects the viscoelastic behavior of biological tissues and plays a key role in arterial elastic recoil and diastolic flow support. In the native aorta, efficient storage and release of mechanical energy are essential for maintaining ventriculo-aortic coupling. The energy dissipation ratio (EDR) quantifies the proportion of mechanical energy lost during a loading-unloading cycle and may provide insight into the biomechanical performance of aortic substitutes. Bovine pericardial patches (BPPs) are widely used in cardiovascular surgery for arterial reconstruction, patch angioplasty, and tubular replacement. Today, EDR has not been systematically investigated in BPPs. Methods: Forty glutaraldehyde-treated BPPs from four commercial manufacturers (n = 10 per supplier) were subjected to low-cycle fatigue testing using a uniaxial tensile system under controlled physiological conditions (37 °C). Standardized bone-shaped specimens were tested at progressive strain percentage levels. Thickness, EDR, and the percentage of specimens failing to reach progressively higher strain levels were evaluated from stress-strain hysteresis loops. Results: BPPs thickness ranged from 0.253 to 0.608 mm, with no significant differences among most groups. For the 10% strain, all BPPs reached the target deformation and demonstrated comparable EDR values. In detail, the mean EDR was 21.40 ± 7.02% for Edwards Lifesciences, 24.95 ± 6.80% for Supple Peri-Guard (Baxter), 24.99 ± 6.04% for Xenosure (LeMaitre), and 23.37 ± 6.12% for Invengenx-Tisgenx, with no statistically significant intergroup differences (p > 0.05). For the 20% strain, only 18.75% of specimens remained structurally intact, and variability increased. At 30% strain, structural failure occurred in nearly all samples. No significant orientation-dependent differences were observed. Conclusions: Commercially available BPPs exhibit similar biomechanical behavior under moderate deformation. However, tolerance to higher strain is limited. EDR analysis provides a clinically relevant parameter to assess elastic performance and may contribute to optimizing aortic substitute selection.

PMID:42646165 | PMC:PMC13514306 | DOI:10.3390/jfb17080362

J Surg Case Rep. 2026 Aug 11;2026(8):rjag698. doi: 10.1093/jscr/rjag698. eCollection 2026 Aug.

ABSTRACT

A 57-year-old woman with known metastatic thymoma who had recently undergone a thoracotomy with resection of a diaphragmatic nodule presented with a symptomatic para-esophageal diaphragmatic hernia. She was managed with an emergency laparoscopic diaphragm repair using a bovine pericardial patch. On visualizing the thoracic cavity through the hernia defect, sub-pneumonic pleural nodules were noted. Although not the primary goal of the surgery, these nodules were resected as re-accessing the thoracic cavity would have been challenging. This case presents a novel minimally invasive approach to the management of a diaphragmatic hernia and incidentally noted metastatic thymoma.

PMID:42583297 | PMC:PMC13460346 | DOI:10.1093/jscr/rjag698

Cell Stem Cell. 2026 Sep 3;33(9):1528-1539.e10. doi: 10.1016/j.stem.2026.07.010. Epub 2026 Aug 11.

ABSTRACT

Therapeutic management of heart valve disease is currently hampered by a lack of mechanistic understanding of human valve development and pathobiology. Here, we develop a protocol to generate three-dimensional human heart valve-like tissues from pluripotent stem cells with enhanced maturational properties that partially recapitulate key molecular features of native valves. This includes an abundance of valve interstitial cells, resident macrophage cells, and the transcriptional profile of native heart valves. Importantly, we define a heart valve maturation signature from proteomic analysis and show that maturation of stem cell-derived valve cells is enhanced under 3D culture. We demonstrate that bioengineered valve-like microtissues can be used for modeling valve disease. Namely, treatment with inflammatory cytokines augmented tissue passive tension and induced molecular hallmarks of valve calcification, consistent with the pathological signature of clinical samples from diseased valves. Thus, bioengineered human heart valve-like tissues provide a platform to understand human heart valve development, maturation, and disease pathogenesis.

PMID:42580349 | DOI:10.1016/j.stem.2026.07.010

J Funct Biomater. 2026 Jul 28;17(8):362. doi: 10.3390/jfb17080362.

ABSTRACT

Background: Energy dissipation reflects the viscoelastic behavior of biological tissues and plays a key role in arterial elastic recoil and diastolic flow support. In the native aorta, efficient storage and release of mechanical energy are essential for maintaining ventriculo-aortic coupling. The energy dissipation ratio (EDR) quantifies the proportion of mechanical energy lost during a loading-unloading cycle and may provide insight into the biomechanical performance of aortic substitutes. Bovine pericardial patches (BPPs) are widely used in cardiovascular surgery for arterial reconstruction, patch angioplasty, and tubular replacement. Today, EDR has not been systematically investigated in BPPs. Methods: Forty glutaraldehyde-treated BPPs from four commercial manufacturers (n = 10 per supplier) were subjected to low-cycle fatigue testing using a uniaxial tensile system under controlled physiological conditions (37 °C). Standardized bone-shaped specimens were tested at progressive strain percentage levels. Thickness, EDR, and the percentage of specimens failing to reach progressively higher strain levels were evaluated from stress-strain hysteresis loops. Results: BPPs thickness ranged from 0.253 to 0.608 mm, with no significant differences among most groups. For the 10% strain, all BPPs reached the target deformation and demonstrated comparable EDR values. In detail, the mean EDR was 21.40 ± 7.02% for Edwards Lifesciences, 24.95 ± 6.80% for Supple Peri-Guard (Baxter), 24.99 ± 6.04% for Xenosure (LeMaitre), and 23.37 ± 6.12% for Invengenx-Tisgenx, with no statistically significant intergroup differences (p > 0.05). For the 20% strain, only 18.75% of specimens remained structurally intact, and variability increased. At 30% strain, structural failure occurred in nearly all samples. No significant orientation-dependent differences were observed. Conclusions: Commercially available BPPs exhibit similar biomechanical behavior under moderate deformation. However, tolerance to higher strain is limited. EDR analysis provides a clinically relevant parameter to assess elastic performance and may contribute to optimizing aortic substitute selection.

PMID:42646165 | PMC:PMC13514306 | DOI:10.3390/jfb17080362

Future Cardiol. 2026 Aug;22(8):799-802. doi: 10.1080/14796678.2026.2713321. Epub 2026 Aug 6.

ABSTRACT

A 70-year-old male with bicuspid aortic valve developed oxacillin-sensitive Staphylococcus aureus bacteremia complicated by infective endocarditis, aortic root abscess, and embolic stroke. Initial management included aortic valve replacement with a bioprosthetic valve, aortic root reconstruction with bovine pericardial patch, and anterior mitral leaflet repair. Despite appropriate antimicrobial therapy, the patient developed recurrent symptoms three years later. Transesophageal echocardiography revealed severe aortic regurgitation and a large pseudoaneurysm resulting from dehiscence of the previous pericardial patch repair. The patient underwent successful repeat sternotomy with aortic root replacement using a valved conduit and reimplantation of coronary arteries. This case highlights the challenging nature of endocarditis involving the aortic root, particularly when complicated by abscess formation requiring patch reconstruction, and emphasizes the importance of long-term surveillance for pseudoaneurysm formation following such complex repairs.

PMID:42561458 | PMC:PMC13540169 | DOI:10.1080/14796678.2026.2713321

Future Cardiol. 2026 Aug;22(8):799-802. doi: 10.1080/14796678.2026.2713321. Epub 2026 Aug 6.

ABSTRACT

A 70-year-old male with bicuspid aortic valve developed oxacillin-sensitive Staphylococcus aureus bacteremia complicated by infective endocarditis, aortic root abscess, and embolic stroke. Initial management included aortic valve replacement with a bioprosthetic valve, aortic root reconstruction with bovine pericardial patch, and anterior mitral leaflet repair. Despite appropriate antimicrobial therapy, the patient developed recurrent symptoms three years later. Transesophageal echocardiography revealed severe aortic regurgitation and a large pseudoaneurysm resulting from dehiscence of the previous pericardial patch repair. The patient underwent successful repeat sternotomy with aortic root replacement using a valved conduit and reimplantation of coronary arteries. This case highlights the challenging nature of endocarditis involving the aortic root, particularly when complicated by abscess formation requiring patch reconstruction, and emphasizes the importance of long-term surveillance for pseudoaneurysm formation following such complex repairs.

PMID:42561458 | PMC:PMC13540169 | DOI:10.1080/14796678.2026.2713321

Multimed Man Cardiothorac Surg. 2026 Aug 6;2026. doi: 10.1510/mmcts.2026.046.

ABSTRACT

Extensive mitral annular calcification represents a major technical challenge in mitral valve surgery and is associated with increased operative mortality and morbidity, including atrioventricular disruption, circumflex artery injury and prosthetic valve dehiscence. Management strategies remain controversial, including in patients suitable for transcatheter interventions. We present a case of severe symptomatic mitral regurgitation in an elderly female patient with extensive circumferential mitral annular calcification. Preoperative imaging confirmed severe mitral regurgitation with restricted calcified mitral leaflets and preserved left ventricular systolic function. Transcatheter mitral valve implantation was considered, but deemed unsuitable because of annular size. The patient therefore underwent endoscopic mitral valve replacement through a right minithoracotomy using femoro-femoral cardiopulmonary bypass. An endoaortic balloon was used to arrest the heart with cardioplegia. After excision of the native valve and limited debridement of calcification, a bioprosthetic mitral valve was implanted and tied with pledgeted braided sutures and an automatic suture knotting device (CorKnot). A bovine pericardial patch was sutured to the posterior portion of the prosthetic sewing ring using a posterior skirt technique to reinforce the posterior annulus and reduce paravalvular leakage risk. Postoperative echocardiography demonstrated a well-functioning prosthetic valve with preserved ventricular function and a trivial paravalvular leak.

PMID:42559759 | DOI:10.1510/mmcts.2026.046

JACC Case Rep. 2026 Aug 25:110004. doi: 10.1016/j.jaccas.2026.110004. Online ahead of print.

ABSTRACT

OBJECTIVE: To demonstrate the technique of totally endoscopic robotic repair of partial atrioventricular septal defect with complex mitral valve reconstruction in an adult patient.

KEY STEPS: Totally endoscopic robotic approach with peripheral cannulation and bicaval control. Bovine pericardial patch closure of the primum atrial septal defect. Left atriotomy for optimal mitral valve exposure. Leaflet shaving, cleft closure, autologous pericardial augmentation, and flexible annuloplasty.

POTENTIAL PITFALLS: Inadequate exposure may compromise assessment of the cleft and leaflet pathology. Careful leaflet remodeling, preservation of leaflet mobility, and avoidance of excessive tension during cleft closure are essential to prevent residual regurgitation or mitral stenosis.

TAKE-HOME MESSAGES: Totally endoscopic robotic repair enables safe and reproducible treatment of partial atrioventricular septal defect with complex mitral valve reconstruction in selected adults. Enhanced visualization and instrument dexterity facilitate precise intracardiac repair while avoiding median sternotomy.

PMID:42640240 | DOI:10.1016/j.jaccas.2026.110004

Sovrem Tekhnologii Med. 2026;18(3):25-36. doi: 10.17691/stm2026.18.3.03. Epub 2026 Jun 30.

ABSTRACT

The aim of the study was to evaluate the biocompatibility of a hybrid material based on epoxy-treated bovine pericardium and cryostructured polyvinyl alcohol (PVA) after implantation into the rat aortic wall and subcutaneous tissue.

MATERIALS AND METHODS: The study evaluated hybrid material patches based on epoxy-treated bovine pericardium and cryostructured PVA; unmodified “KemPeriplasNeo” pericardial patches served as controls. The samples were implanted into the abdominal aortic wall and subcutaneously in male Wistar rats. The vascular implantation periods were 5 and 20 days, and the subcutaneous implantation periods were 60 and 120 days. The specimens were excised from the aorta and studied histologically using Russell-Movat staining and immunostaining for neutrophil myeloperoxidase (MPO) and the macrophage marker CD68. The calcium content in subcutaneously implanted samples was assessed by spectrophotometry and alizarin red S staining. The quantitative data were presented as the median, percentiles, minimal and maximal values (Me [25%-75%; min-max]).

RESULTS: After implantation into the abdominal aortic wall, the hybrid material samples showed a lower tendency toward thrombotic deposit formation on the surface compared to the pericardium. On day 5 of implantation, the thrombus thickness was 49.1 [34.7-64.6; 27.4-71.6] μm in the experimental group vs 170.3 [158.1-210.3; 124.4-217.0] μm in the controls (p<0.001). By day 20 of implantation, the macrophage density was lower in the peri-implant area of the modified samples compared to the controls: 219 [187-275; 112-362] vs 301 [244-338; 194-433] CD68⁺ cells per field of view (p<0.001), respectively. The neutrophil density at all experimental time points, as well as the macrophage density on day 5 of implantation did not differ significantly between the tested materials (p>0.17). No signs of calcification were detected in either group following the subcutaneous implantation over a period of 60 or 120 days. The control pericardium in the subcutaneous model showed the signs of cell-mediated degradation, whereas the hybrid samples were resistant to immune-cell infiltration and preserved their internal architecture.

CONCLUSION: The modification of epoxy-treated bovine pericardium with cryostructured PVA cryogel improved its biocompatibility and enhanced resistance to biodegradation in a rat model after aortic-wall and subcutaneous implantation. The developed material may be used to create next-generation heart valve bioprostheses with potentially improved resistance to structural valve degeneration.

PMID:42524404 | PMC:PMC13410878 | DOI:10.17691/stm2026.18.3.03