Month: September 2026

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

Kyobu Geka. 2026 Jun;79(6):447-450.

ABSTRACT

Mitral annular calcification (MAC) increases the risk of left ventricular rupture during mitral valve replacement (MVR). We report an 81-year-old woman with severe MAC who underwent MVR with preservation of the posterior leaflet and subvalvular apparatus, combined with selective annular debridement using an ultrasonic surgical aspirator and annular reinforcement with a bovine pericardial patch. The valve prosthesis was sewn into place with special attention to suture needle position. Our maneuver enabled safe calcification removal and implantation of an adequately sized prosthesis without left ventricular rupture or paravalvular leakage. Postoperative left ventricular function was well preserved, and the prosthetic valve showed good performance. This technique may reduce the risks of left ventricular rupture and prosthesis-patient mismatch during MVR in patients with severe MAC.

PMID:42722487

Kyobu Geka. 2026 Jul;79(7):537-541.

ABSTRACT

The infected brachiocephalic arterial aneurysm is a very rare but highly lethal, life-threatening, and difficult-to-treat condition. We report a case of infected brachiocephalic arterial aneurysm involving ascending aorta. An 81-year-old woman with a history of colon diverticulitis was referred to our hospital because of infected brachiocephalic aneurysm. Emergent operation was performed because the aneurysm grew rapidly. The aneurysm was excised, extra-anatomical grafting was performed with a prosthetic vascular graft and the ascending aorta was repaired with bovine pericardium patch. The aortic infection was successfully cured postoperatively, but she died of peritonitis. Due to the rarity, history-taking and physical examination should be thorough, and symptoms and signs should be closely analyzed.

PMID:42722462

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

Multimed Man Cardiothorac Surg. 2026 Sep 8;2026. doi: 10.1510/mmcts.2026.052.

ABSTRACT

This case report describes the robot assisted resection of a 70 year old man’s anterior mediastinal mass. Preoperative imaging showed an 85 × 45 mm thymic squamous cell carcinoma invading the pericardium and occluding the left innominate vein. After neoadjuvant chemotherapy, a bilateral robotic approach was used. The phrenic nerves and great vessels were skeletonized; the left innominate vein was encircled and transected with a vascular stapler; the mass was mobilized off the sternum; the pericardium was opened and resected en bloc with the tumour; and the robot was re docked on the right to dissect the right phrenic nerve and control the superior vena cava, which underwent stapled plasty before division of the left innominate vein. Reconstruction included a bovine pericardial patch. Operative time was 300 minutes with no intraoperative complications; the patient developed transient atrial fibrillation and was discharged on Day 9. Final pathology confirmed an R0 resection. This case highlights that robot assisted thoracic surgery can safely manage complex mediastinal tumours involving the pericardium and great vessels, offering advantages in blood loss and recovery compared with sternotomy.

PMID:42713653 | DOI:10.1510/mmcts.2026.052

Med Sci (Basel). 2026 Jul 21;14(3):411. doi: 10.3390/medsci14030411.

ABSTRACT

Background: Current ESC/EACTS guidelines recommend bioprosthetic valves for aortic valve replacement (AVR) in patients > 65 years, yet their use is increasing among younger individuals. The INSPIRIS Resilia (IR) valve, a next-generation bioprosthesis, was designed to improve durability and reduce structural valve degeneration (SVD). This study compares clinical and valve-related outcomes up to six years in patients undergoing AVR with either the IR or its predecessor, the Perimount Magna Ease (PME) valve. Methods: Between January 2017 and December 2023, 2053 patients underwent isolated or combined AVR at a single institution (1602 PME; 451 IR). Propensity-score matching identified 224 patient pairs with comparable baseline characteristics. Outcomes were assessed over follow-up extending up to six years, focusing on cardiovascular and valve-related adverse events. Transvalvular gradients were also assessed at follow-up. Results: After matching, mean age was 64.2 ± 7.7 years in both groups. Freedom from cardiovascular mortality at six years was similar between PME and IR (96.6% vs. 98.2%; p = 0.34), as were rates of stroke, rehospitalization, prosthetic valve endocarditis, and reintervention. A total of 12 PME (5.4%) and six IR valves (2.5%) were explanted during follow-up (p = 0.15), with prosthetic endocarditis representing the leading cause of reintervention. Only one case of severe SVD was observed in both groups. Conclusions: In patients undergoing AVR with comparable baseline risk profiles, IR and PME valves demonstrated similar clinical, valve-related, and hemodynamic outcomes up to six years of follow-up. Prosthetic valve endocarditis represented the leading cause of valve failure, whereas structural valve deterioration remained rare. Longer follow-up and a greater number of valve-related events will be necessary to determine whether differences in bioprosthetic valve degeneration emerge over time.

PMID:42506380 | PMC:PMC13413634 | DOI:10.3390/medsci14030411

Biomech Model Mechanobiol. 2026 Jul 21;25(4):84. doi: 10.1007/s10237-026-02112-3.

ABSTRACT

Transcatheter aortic valves (TAVs) typically operate on non-circular rings, but the impact of annular ellipticity on valve mechanics remains insufficiently quantified. In this study, we present a finite element (FE) framework of a 27 mm Allegra TAV that reproduces the complete model, including stent and pericardial skirt and leaflets. The leaflets were represented using a general shell formulation that decouples the in-plane and bending responses, leading to a hybrid shell-membrane finite element model. A linear elastic constitutive law was calibrated through inverse FE analysis based on cantilever bending experiments performed on bovine pericardium. The model was validated against in vitro pulse duplicator tests for circular and highly elliptical geometries, reproducing distinctive features such as full systolic opening and the asymmetric ‘pinwheel’ pattern during diastolic closure. Once validated, the model is used to investigate the impact of annular ellipticity across six annular aortic geometries. Each geometry was evaluated in two limiting orientations of the ellipse’s major axis (0 ∘ and 90 ∘ ) to analyse the model response in terms of valve coaptation. These results identify annular geometry and alignment as major factors in valve leaflet coaptation asymmetry and this asymmetry was found to correlate with increased stress concentration, which could compromise long-term valve function.

PMID:42479090 | PMC:PMC13388641 | DOI:10.1007/s10237-026-02112-3

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

Gen Thorac Cardiovasc Surg. 2026 Aug 19. doi: 10.1007/s11748-026-02380-x. Online ahead of print.

ABSTRACT

BACKGROUND: Surgical treatment of symptomatic diaphragmatic paralysis or eventration classically relies on suture plication of the elevated hemidiaphragm. We describe an alternative technique-overlay reconstruction of the diaphragm using a bovine pericardial patch (Peri-Guard®) without formal plication sutures-and report its feasibility, safety, and radiographic outcomes.

METHODS: We retrospectively reviewed consecutive patients undergoing diaphragmatic overlay reconstruction with a Peri-Guard® patch at Hannover Medical School between January 2020 and May 2025. Demographic, perioperative, and radiographic data were collected. Diaphragmatic elevation was quantified on chest radiographs using the interdiaphragmatic height difference (IHD) and relative IHD (rIHD). Preoperative and postoperative measurements were compared.

RESULTS: Thirteen patients underwent patch-based diaphragmatic overlay reconstruction. Mean age was 60.0 ± 9.3 years, and mean body mass index was 29.4 ± 4.9 kg/m². Dyspnoea was the predominant symptom (84.6%). Mean operative time was 124.7 ± 31.7 min; all patients were extubated in the operating room, and there was no perioperative mortality. Mean IHD decreased from 7.32 ± 2.94 cm preoperatively to – 0.29 ± 2.24 cm postoperatively (p < 0.001); mean rIHD decreased from 31.22 ± 11.49 to – 1.47 ± 9.42% (p < 0.001). Exploratory analyses found no significant association between BMI and postoperative radiographic outcomes.

CONCLUSIONS: In this small retrospective series, patch-based diaphragmatic overlay reconstruction was technically feasible and was associated with marked early radiographic correction of diaphragmatic elevation. Comparative studies against conventional suture plication are needed to determine relative durability and functional benefit.

PMID:42616317 | DOI:10.1007/s11748-026-02380-x