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Am J Case Rep. 2026 Jan 9;27:e950499. doi: 10.12659/AJCR.950499.

ABSTRACT

BACKGROUND Tracheogastric conduit fistula (TGCF) is a rare but life-threatening complication of esophagectomy, particularly in high-risk patients with comorbidities or prior chemoradiotherapy. It typically develops in the setting of anastomotic leakage, ischemia, or infection. There is no standardized treatment, and outcomes vary depending on timing and surgical approach. We report a delayed TGCF after thoracolaparoscopic esophagectomy and describe the operative technique and key perioperative considerations. CASE REPORT A 78-year-old man with diabetes, hypertension, and a heavy smoking history underwent thoracolaparoscopic esophagectomy for Siewert type I adenocarcinoma following neoadjuvant chemoradiotherapy. On postoperative day 54, persistent coughing prompted imaging and endoscopy, which revealed a tracheogastric fistula between the gastric conduit and posterior membranous trachea. Surgical repair was performed via right thoracotomy, involving debridement, closure of the gastric and tracheal defects, and interposition of a vascularized intercostal muscle flap. Reinforcement with fibrin sealant and a bovine pericardial patch was applied. Initial bronchoscopy confirmed airtight repair. However, the patient later developed recurrent pneumonia and septic shock, ultimately dying to multiorgan failure on postoperative day 108. CONCLUSIONS This case illustrates the complex management of TGCF and reinforces the value of early recognition and aggressive surgical intervention. Despite the fatal outcome, the absence of fistula recurrence confirmed the technical success and offers insight for managing similar high-risk cases. Intercostal muscle flap remains a reliable option for fistula closure in irradiated and infected fields. Meticulous surgical planning and perioperative management are essential for optimizing outcomes in this rare complication.

PMID:41508572 | PMC:PMC12814743 | DOI:10.12659/AJCR.950499

Surg Neurol Int. 2026 Jan 23;17:46. doi: 10.25259/SNI_1245_2025. eCollection 2026.

ABSTRACT

BACKGROUND: Aplasia cutis congenita (ACC) is a rare congenital condition marked by the absence of skin layers and sometimes underlying structures. Its etiology is unclear, with up to 70% of cases involving the scalp. We report the first document case of ACC in Ghana.

CASE DESCRIPTION: A 1-day-old female, born through spontaneous vaginal delivery after an uneventful pregnancy, was referred for management of a scalp defect noted at birth. Examination revealed an 8 × 5.5 cm central scalp defect with absent cranial vault, partial fronto-parietal bone loss, dural defect, exposed arachnoid membranes, and visible superior sagittal sinus. Other physical findings were normal. Brain magnetic resonance imaging (MRI), whole-body MRI, and echocardiography were unremarkable. A brain computed tomography confirmed a skull defect. The patient underwent a duraplasty using bovine pericardium and received serial wound dressings with epithelial growth factors. The defect reduced to 4.5 × 3.6 cm post-surgery and continues to improve pending potential cranioplasty at 2 years. ACC is primarily diagnosed clinically, and this patient was diagnosed with type 1 ACC. Management depends on subtype, location, defect size, and infection risk. In this case, surgery was employed due to the size of defect and the risk it posed. Prognosis is generally favorable, but limited resources may delay and increase complications in low-income settings.

CONCLUSION: ACC with skull and dural involvement poses serious risks to infant survival in resource-limited settings, where systemic challenges are pervasive. This case highlights the importance of care that is locally adapted, affordable, and delivered through strong multidisciplinary collaboration.

PMID:41660340 | PMC:PMC12875229 | DOI:10.25259/SNI_1245_2025

Interdiscip Cardiovasc Thorac Surg. 2026 Feb 5;41(2):ivag036. doi: 10.1093/icvts/ivag036.

ABSTRACT

OBJECTIVES: The optimal choice of bioprosthetic valve for mitral valve replacement (MVR) remains controversial, with prior studies reporting inconsistent outcomes. This study aimed to compare mid-term clinical performance between bovine pericardial and porcine bioprostheses using a hierarchical composite end-point reflecting both durability and clinical relevance, including cardiac death, reoperation, and haemodynamic structural valve deterioration (SVD).

METHODS: This retrospective study included 304 patients (152 per group) who underwent bioprosthetic MVR between 2007 and 2020, following 1:1 propensity score (PS) matching. The primary outcome was a hierarchical composite of cardiac death, reoperation for SVD, and echocardiographic diagnosis of haemodynamic SVD. Secondary outcomes included overall survival and perioperative complications.

RESULTS: The median clinical follow-up durations were 7.3 years in the bovine group and 5.3 years in the porcine group. The win ratio was 1.49 (95% CI, 1.21-1.83; P < .001), indicating a statistically significant difference favouring the bovine group. While overall survival and freedom from cardiac death were comparable between groups, the cumulative incidence of reoperation for SVD and haemodynamic SVD diagnosis were significantly higher in the porcine group (Gray’s P = .031 and 0.037, respectively).

CONCLUSIONS: In this propensity-matched analysis, bovine pericardial valves showed a modest, consistent mid-term durability signal on SVD-related components, with similar overall survival. These findings are hypothesis-generating and should inform individualized prosthesis selection rather than dictate device choice; model-specific prospective studies, ideally randomized controlled trials, are needed for definitive guidance.

PMID:41701171 | PMC:PMC12927412 | DOI:10.1093/icvts/ivag036

Beyoglu Eye J. 2026 Jan 19;10(4):250-253. doi: 10.14744/bej.2025.25932. eCollection 2025.

ABSTRACT

OBJECTIVES: In this study, a new technique that does not cause lower eyelid retraction in patients with excessive limitation of movement and vertical strabismus due to inferior rectus (IR) fibrosis in thyroid eye disease was introduced.

METHODS: There were six patients with their six eyes with their mid-term results.

OPERATION TECHNIQUE: According to the deviation amount, a 7-14 mm length bovine pericardium (Tutopatch®) was inserted between the distal end of the tendon and the beginning of the muscle fibers, which are located between the tendon’s distal end and the tendon muscle junction to the IR with 6/0 non-absorbable suture.

RESULTS: There were six cases with a mean 19.5±5.2 PD (PD: prism diopters) (14-26 PD) vertical deviation and severe up-gaze limitations with a mean -4.1±0.75. The post-operative vertical deviation was a mean of 3.5±1.22 PD, and the limitation of upgaze was a mean of -1.3±0.4.

CONCLUSION: This procedure provides effective results in reducing gaze limitation and vertical deviation in thyroid patients without causing any problems in the eyelids.

PMID:41658259 | PMC:PMC12875192 | DOI:10.14744/bej.2025.25932

Sci Rep. 2026 Feb 4;16(1):7315. doi: 10.1038/s41598-026-35729-6.

ABSTRACT

As the demand for aortic valve prostheses grows, optimizing their mechanical performance and durability is essential. While mechanical valves offer longevity, their need for lifelong anticoagulation limits their use, making bioprosthetic valves a preferred alternative. However, bioprosthetic valves made from bovine pericardium face durability challenges due to structural degradation. Given that valve functionality is heavily influenced by the collagen architecture and mechanical properties of the tissue, selecting an optimal replacement is essential. This study evaluates treated ovine aortic valves as an alternative material, comparing their mechanical behavior to native human valves. Tensile tests showed an elastic modulus of 20.17 MPa for treated ovine leaflets, while human leaflets ranged from 6.15 MPa to 28.10 MPa. Stress relaxation tests indicated a 41% stress reduction in treated ovine valves compared to 21% in human valves after 300 s, suggesting greater viscoelasticity. Finite element analysis revealed lower peak systolic stress in treated ovine valves (0.36 MPa vs. 0.72 MPa in human valves), with stress distributions aligning with clinically observed degradation sites. These findings highlight ovine tissue’s potential for improved durability and flexibility, making it a strong candidate for next-generation bioprosthetic heart valves.

PMID:41639159 | PMC:PMC12923552 | DOI:10.1038/s41598-026-35729-6

Sci Rep. 2026 Feb 4;16(1):7315. doi: 10.1038/s41598-026-35729-6.

ABSTRACT

As the demand for aortic valve prostheses grows, optimizing their mechanical performance and durability is essential. While mechanical valves offer longevity, their need for lifelong anticoagulation limits their use, making bioprosthetic valves a preferred alternative. However, bioprosthetic valves made from bovine pericardium face durability challenges due to structural degradation. Given that valve functionality is heavily influenced by the collagen architecture and mechanical properties of the tissue, selecting an optimal replacement is essential. This study evaluates treated ovine aortic valves as an alternative material, comparing their mechanical behavior to native human valves. Tensile tests showed an elastic modulus of 20.17 MPa for treated ovine leaflets, while human leaflets ranged from 6.15 MPa to 28.10 MPa. Stress relaxation tests indicated a 41% stress reduction in treated ovine valves compared to 21% in human valves after 300 s, suggesting greater viscoelasticity. Finite element analysis revealed lower peak systolic stress in treated ovine valves (0.36 MPa vs. 0.72 MPa in human valves), with stress distributions aligning with clinically observed degradation sites. These findings highlight ovine tissue’s potential for improved durability and flexibility, making it a strong candidate for next-generation bioprosthetic heart valves.

PMID:41639159 | PMC:PMC12923552 | DOI:10.1038/s41598-026-35729-6

Rev Med Liege. 2025 Dec;80(12):770-775.

ABSTRACT

Prosthetic vascular infections are rare, occurring in less than 3 % of cases. If left untreated within the required timeframe, serious complications such septic shock and anastomotic rupture with hemorrhage may occur and lead to the patient’s death. Targeted and prolonged intravenous or oral antibiotic therapy is necessary but insufficient without surgical revision and removal of the infected prosthetic material. Once the infected prosthetic material is removed, blood continuity must be restored to ensure downstream vascularization and avoid amputation. There are two types of repair: extra-anatomical and in situ reconstructions. For the latter, it is ideal to avoid using prosthetic material. The solutions described in the literature are most often autologous venous grafts and cryopreserved arterial allografts. These are not always available. An alternative is to use a bovine pericardial patch, shaping it into a tube on the table with a longitudinal suture. We report a case of an infected common femoral artery prosthesis replaced with a pericardial patch and covered with the sartorius muscle.

PMID:41392629

Rev Col Bras Cir. 2026 Jan 23;52:e20253835. doi: 10.1590/0100-6991e-20253835-en. eCollection 2026.

ABSTRACT

INTRODUCTION: Surgical site infection (SSI) and polypropylene mesh (PPM) infections are recurrent problems in abdominal hernia surgeries, highlighting the need for a new antimicrobial material for surgical repair. The aim of this study was to evaluate the in vivo antimicrobial effect of a new biological mesh made of decellularized bovine pericardium (BP), added with vancomycin (VAN) or silver nanoparticles (AgNPs), as prevention for SSI.

METHODS: Thirty-five Wistar rats were divided into four groups: BP C+ (n=9) with BP without additions; PP C+ (n=8) with PPM; BP AgNPs (n=9) with BP added with silver nanoparticles; and BP VAN (n=9) with BP added with vancomycin. The 1 cm² meshes were stitched into the muscle fascia under the subcutaneous tissue of the rats’ backs, followed by inoculation with methicillin-resistant Staphylococcus aureus. The animals were observed for 7 days, with subsequent euthanasia, and histological and bacteriological analysis.

RESULTS: The BP VAN group had better infection control compared to the PP C+ and BP AgNPs groups (1×10¹ vs. 1.4×10³CFU/g, p=0.0303; 1×10¹ vs. 1.5x104CFU/g, p<0.0001, respectively). BP AgNPs showed less bacterial reduction compared to BP C+ (p=0.042). In the histological analysis, there was a mild inflammatory reaction in BP VAN, moderate in BP C+, and intense in PP C+ and BP AgNPs.

CONCLUSION: BP added with vancomycin showed promising antimicrobial action, while the use of silver nanoparticles did not demonstrate efficacy in this study.

PMID:41615166 | DOI:10.1590/0100-6991e-20253835-en

Medicine (Baltimore). 2026 Jan 16;105(3):e47074. doi: 10.1097/MD.0000000000047074.

ABSTRACT

Teflon felt (TFF) is widely adopted for microvascular decompression surgeries (MVDS) for hyperactivity syndrome involving the trigeminal neuralgia (TGN) and hemifacial spasm (HFS) while bovine pericardial patch (BPP) used for dural graft and not MVDS. We speculated that BPP roll around the nerve like an eggroll and fixed with a closing suture may solve the complications associated with TFF dependent MVDS and reduce hospital cost. We conducted a comparative retrospective study on all MVDS for TGN and HFS performed at the department of Neurosurgery, West China Hospital from January 1, 2015, to January 1, 2022. Data like clinical and imaging characteristics, operative procedures, postoperative complications, recurrence rate were recorded and compared between patients who underwent TFF and BPP MVDS. We observed a significant statistical difference (P = .0135) in recurrence and granuloma formation between the TFF and BPP MVDS. The time of recurrence and the annual rate of control of symptomatology were almost same in both groups until 30 months onwards where cases of recurrences were high in the TFF MVDS (4.2% vs 0%; P = .0135, 95% CI: 1.8-6.5%). Also, total cost was relatively lower in BPP MVDS compare to the TFF MVDS (P = .00135). BPP roll around the nerve like an eggroll and fixed with a closing suture could be a good alternative for TFF dependent MVDS. Notably, the BPP MVDS had no granuloma formation and no recurrence of symptomatology.

PMID:41560012 | PMC:PMC12826271 | DOI:10.1097/MD.0000000000047074

Gen Thorac Cardiovasc Surg. 2026 Jan 13. doi: 10.1007/s11748-025-02253-9. Online ahead of print.

ABSTRACT

OBJECTIVE: Pulmonary vein stenosis is a rare but serious complication following catheter ablation for atrial fibrillation. This study aimed to evaluate the mid-term outcomes of the sutureless marsupialization technique for acquired pulmonary vein stenosis or pulmonary vein occlusion.

METHODS: Between 2006 and 2024, six patients (mean age: 54.5 ± 9.0 years) with severe pulmonary vein stenosis or pulmonary vein occlusion after catheter ablation underwent surgical repair using the sutureless marsupialization technique. This approach avoids direct suturing to the pulmonary vein wall by covering the opened vein with autologous or xenogeneic tissue (left atrial appendage, pericardium, or atrial wall). A total of 13 pulmonary veins were reconstructed. Restenosis was evaluated using follow-up computed tomography, and 5-year patency was estimated by Kaplan-Meier analysis.

RESULTS: All patients underwent successful repair without perioperative complications. Covering materials included the left atrial appendage (n = 3), bovine pericardium (n = 2), autologous pericardium (n = 1), and atrial wall flap (n = 1). During a mean follow-up of 62.5 ± 46.5 months, restenosis occurred in 2 of 13 veins (15.4%) four months after surgery, both initially classified as stenotic lesions. All patients remained asymptomatic and required no further intervention. The 5-year patency rate was 84.6%.

CONCLUSIONS: The sutureless marsupialization technique offers good mid-term outcomes for acquired pulmonary vein stenosis and pulmonary vein occlusion after catheter ablation. By avoiding direct vein wall suturing, this approach may reduce restenosis. These results support its potential as a surgical option in selected patients with this rare complication.

PMID:41528589 | DOI:10.1007/s11748-025-02253-9