Author:

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

BMC Oral Health. 2026 May 6. doi: 10.1186/s12903-026-08397-1. Online ahead of print.

ABSTRACT

BACKGROUND: The porcine acellular urinary bladder matrix (AUBM) is a three-dimensional scaffold rich in collagens type I, III, IV, and VI that could be used for guided bone regeneration (GBR). The objective of this study was to compare the physical, mechanical and biological properties of a AUBM with six other collagen membranes of porcine, equine and bovine origin.

METHODS: Seventy membranes were included (n = 10 per group). The properties of AUBM membrane were compared with the other animal collagen membranes available: porcine pericardium (PP), equine pericardium (EP), bovine pericaridium (BP), porcine peritoneum (PPE), equine Achilles tendon (EAT), bovine Achilles tendon (BAT). We analysed physical properties (surface morphology, hydrophilic property, degradation ratio and thermal stability), mechanical properties (tensile strength and dry and wet elongation), and biological properties (cell viability, quantification of type I collagen and osteopontin, Alkaline Phosphatase (ALP) activity and calcium deposition).

RESULTS: AUBM membranes showed a surface morphology (in smooth and rough surfaces) very similar to those of PP, EP, EAT, and BAT. The most hydrophilic membrane was PPE. The AUBM membranes showed a low degradation ratio and thermal stability similar to the other membranes. AUBM membranes had a tensile strength (dry and wet) and elongation (dry) similar to the other membranes. Their elongation was much higher than the rest when wet. AUBM membrane showed good biological properties.

CONCLUSIONS: AUBM membrane showed physical and mechanical properties similar to the other six membranes. However, upon wetting they were the membranes with the highest elongation capacity and showed similar properties to PPE membranes in promoting osteogenesis. AUBM could be an ideal collagen source for the manufacture of membranes for GBR, but further clinical studies are needed.

PMID:42092872 | DOI:10.1186/s12903-026-08397-1

Multimed Man Cardiothorac Surg. 2026 May 6;2026. doi: 10.1510/mmcts.2026.003.

ABSTRACT

Tricuspid regurgitation, associated with poor functional status and reduced survival, is common in patients with rheumatic heart disease after left-sided valve replacement. Although repair is preferred over replacement, surgical repair remains technically challenging. A 60-year-old woman presented with recurrent bilateral leg oedema for 2 years and dizziness with palpitations for 2 months. She had undergone mechanical mitral and aortic valve replacement 18 years earlier for rheumatic heart disease. Echocardiography demonstrated severe central tricuspid regurgitation with preserved prosthetic valve function and atrial arrhythmia. Via median sternotomy and cardiopulmonary bypass, classic rheumatic pathology of the tricuspid valve was identified. Repair consisted of detachment of the anterior and posterior leaflets, augmentation with an annuloplasty-shaped bovine pericardial patch to increase leaflet height and coaptation, and implantation of a partial rigid annuloplasty ring slightly smaller than the patch. Intra-operative echocardiography showed trace residual tricuspid regurgitation. Recovery was uneventful, with early resolution of oedema. Leaflet augmentation combined with partial ring annuloplasty is a simple and reproducible technique that restores early valve competence in complex rheumatic tricuspid regurgitation. Long-term follow-up is required to confirm durability.

PMID:42087840 | DOI:10.1510/mmcts.2026.003

Cardiol Young. 2026 May 14:1-3. doi: 10.1017/S1047951126113067. Online ahead of print.

ABSTRACT

Left ventricular pseudoaneurysm is an exceedingly rare, life-threatening complication following percutaneous balloon aortic valvuloplasty. We report a 1-month-old infant presenting with a large left ventricular pseudoaneurysm after successful valvuloplasty for critical aortic stenosis. Multimodal imaging confirmed the diagnosis. The patient underwent successful surgical resection and bovine pericardial patch repair. This case emphasises the importance of early surgical intervention for favourable outcomes.

PMID:42130344 | DOI:10.1017/S1047951126113067

Int J Biol Macromol. 2026 May;361:151831. doi: 10.1016/j.ijbiomac.2026.151831. Epub 2026 Apr 23.

NO ABSTRACT

PMID:42031605 | DOI:10.1016/j.ijbiomac.2026.151831

Int J Biol Macromol. 2026 May;361:151831. doi: 10.1016/j.ijbiomac.2026.151831. Epub 2026 Apr 23.

NO ABSTRACT

PMID:42031605 | DOI:10.1016/j.ijbiomac.2026.151831

Oper Neurosurg. 2026 Jun 3. doi: 10.1227/ons.0000000000002083. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Circumferential defects of the dural sleeve of exiting lumbar nerve roots may occur after incidental durotomy, trauma, or deliberate opening of the root cuff during resection of nerve sheath tumors. Standard onlay duraplasty can control cerebrospinal fluid (CSF) leakage but does not restore the tubular dural-epineural conduit. We describe a collagen-matrix cuff technique for root sleeve reconstruction and report our initial institutional experience.

METHODS: This single-center, retrospective case series includes 9 consecutive reconstructions performed between January 2022 and October 2025 for intraoperatively recognized circumferential defects of exiting lumbar nerve root sleeves not amenable to safe primary suturing. The cohort comprised 6 iatrogenic root sleeve defects occurring during elective lumbar procedures (including instrumented and noninstrumented decompressive and/or stabilizing surgeries), 2 post-traumatic cases, and 1 elective tumor case presented as the illustrative case (L3 nerve root ganglioneuroma resection). Clinical records, intraoperative notes, and imaging were reviewed retrospectively. Minimum clinical and MRI follow-up was 6 months for all patients. Adjunctive lumbar drainage was used in one iatrogenic case.

RESULTS: In all cases, a bovine pericardium-derived collagen matrix was prehydrated, tailored, positioned under the root, sutured proximally to the dural margin at the root axilla, and wrapped to form a tubular cuff bridging the dural sac to the epineural segment, with distal reinforcement using fat and fibrin sealant. No patient required reoperation for CSF leak or pseudomeningocele. There were no cases of symptomatic nerve root herniation or new permanent neurological deficit. Radicular symptoms were stable or improved at the last follow-up.

CONCLUSION: Collagen-matrix cuff reconstruction is a simple, anatomically oriented option for circumferential lumbar root sleeve defects when primary closure is not feasible. In this initial single-center experience, the technique provided stable reconstruction without CSF-related complications and may represent a useful adjunct in selected complex root sleeve injuries.

PMID:42233683 | DOI:10.1227/ons.0000000000002083

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