Author:

Ann R Coll Surg Engl. 2026 Jan 12. doi: 10.1308/rcsann.2025.0116. Online ahead of print.

ABSTRACT

INTRODUCTION: Infected aortic fields are among the most complex surgical challenges, often requiring urgent intervention and associated with a high risk of morbidity and mortality. Bovine pericardium offers a customisable, off-the-shelf option for in situ reconstruction using biological material. We evaluate long-term outcomes following emergency bovine pericardium neo-aorta reconstruction in infected aortic fields.

METHODS: Prospectively collected data for all patients treated with bovine pericardium neo-aorta reconstructions from 2018 to date were analysed. The surgical approach included resection of the infected aortic segment, explantation of previous grafts and/or stents, and reconstruction of the neo-aorta using a bovine pericardium sheet. Data collected included patient demographics, comorbidities, clinical presentation, previous interventions, blood tests, complications, length of antibiotic treatment and long-term survival. All neo-aortas were enrolled in an annual ultrasound surveillance programme to monitor for aneurysmal degeneration.

RESULTS: Fifteen aortic reconstructions were performed. The most common indication was aorto-enteric fistulas (n = 7), followed by infected aortic grafts (n = 4), mycotic aneurysms (n = 3) and one contaminated field due to emergency colectomy. Median follow-up was 34 months (range 9-84). Thirty-day mortality was 7%, with another 7% at 10 weeks. Antibiotic-free survival rate was 86%. One patient (7%) required long-term antibiotics post-partial endovascular aneurysm repair explant. Complications included one graft occlusion with limb loss and one case of end-stage renal failure. No aneurysmal degeneration was identified during follow-up.

CONCLUSION: Bovine pericardial neo-aorta reconstructions have shown excellent long-term resistance to infections and very good durability. Our data add to growing evidence supporting off-the-shelf use of bovine pericardium in emergency aortic reconstruction. Larger numbers through multicentre studies or special registries would help support more regular use.

PMID:41524123 | DOI:10.1308/rcsann.2025.0116

Ophthalmologie. 2026 Feb 17. doi: 10.1007/s00347-026-02398-9. Online ahead of print.

ABSTRACT

A 34-year-old male patient with primary juvenile open-angle glaucoma presented 3 months after trabeculectomy with mitomycin C in the left eye due to progressive visual deterioration. Ocular hypotension with an intraocular pressure of 2 mmHg was noted along with a prominent filtering bleb and macular folding of the retina and choroid as the cause of reduced visual acuity. The diagnosis of hypotony maculopathy was established. After an initial lack of improvement, revision surgery was performed. Intraoperatively, a very thin and undersized scleral flap with a torn suture as well as a disproportionately large sclerectomy were identified, rendering adequate suture revision impossible. Therefore, the fistulation site was covered with a 5 × 5 mm Lyoplant® implant (Aesculap, Braun, Melsungen, Germany, acellular bovine pericardium) and secured with sutures to achieve controlled reduction of aqueous humor filtration. The postoperative course was uneventful. The intraocular pressure normalized to 12 mmHg 6 weeks after revision surgery, visual acuity improved and optical coherence tomography demonstrated a normal macula. This case highlights the importance of adequate size and thickness of the scleral flap, particularly in young patients with more compliant sclera, to prevent hyperfiltration and hypotony maculopathy. Coverage of the scleral fistula with bovine pericardium proved to be an effective surgical treatment option.

PMID:41701367 | DOI:10.1007/s00347-026-02398-9

J Surg Case Rep. 2026 Jan 2;2026(1):rjaf1025. doi: 10.1093/jscr/rjaf1025. eCollection 2026 Jan.

ABSTRACT

We report a 70-year-old woman (body surface area 1.42 m²) undergoing redo double valve replacement with extensive annular enlargement using the Commando procedure. Thirteen years earlier, she received aortic valve replacement (St. Jude Medical 19 mm), mitral repair (Physio Ring 24 mm), and tricuspid annuloplasty. She presented with progressive heart failure; echocardiography showed severe mitral stenosis (mitral valve area 0.96 cm²) and moderate aortic stenosis with moderate paravalvular leak. To avert patient-prosthesis mismatch (PPM), both annuli were enlarged with bovine pericardium, permitting implantation of an Epic 27 mm mitral and an Inspiris 23 mm aortic bioprosthesis. Postoperative echocardiography demonstrated excellent hemodynamics (aortic effective orifice area 1.76 cm², mean gradient 6 mmHg; mitral mean gradient 3 mmHg). Recovery was uneventful, and she remains asymptomatic. Commando surgery enabled safe, simultaneous enlargement of both annuli, minimizing PPM, and preserving options for future valve-in-valve therapy.

PMID:41487892 | PMC:PMC12757946 | DOI:10.1093/jscr/rjaf1025

Ophthalmologie. 2026 Feb 17. doi: 10.1007/s00347-026-02398-9. Online ahead of print.

ABSTRACT

A 34-year-old male patient with primary juvenile open-angle glaucoma presented 3 months after trabeculectomy with mitomycin C in the left eye due to progressive visual deterioration. Ocular hypotension with an intraocular pressure of 2 mmHg was noted along with a prominent filtering bleb and macular folding of the retina and choroid as the cause of reduced visual acuity. The diagnosis of hypotony maculopathy was established. After an initial lack of improvement, revision surgery was performed. Intraoperatively, a very thin and undersized scleral flap with a torn suture as well as a disproportionately large sclerectomy were identified, rendering adequate suture revision impossible. Therefore, the fistulation site was covered with a 5 × 5 mm Lyoplant® implant (Aesculap, Braun, Melsungen, Germany, acellular bovine pericardium) and secured with sutures to achieve controlled reduction of aqueous humor filtration. The postoperative course was uneventful. The intraocular pressure normalized to 12 mmHg 6 weeks after revision surgery, visual acuity improved and optical coherence tomography demonstrated a normal macula. This case highlights the importance of adequate size and thickness of the scleral flap, particularly in young patients with more compliant sclera, to prevent hyperfiltration and hypotony maculopathy. Coverage of the scleral fistula with bovine pericardium proved to be an effective surgical treatment option.

PMID:41701367 | DOI:10.1007/s00347-026-02398-9

Ann Vasc Surg. 2025 Dec 31;125:196-205. doi: 10.1016/j.avsg.2025.12.030. Online ahead of print.

ABSTRACT

BACKGROUND: Biological grafts are the preferred option for in situ aortic reconstruction following infections, offering good survival and low complications rates. Vein harvesting may be challenging or undoable in emergency setting. Hence, xenogeneic materials, such as bovine grafts, gained popularity due to their availability, biocompatibility, and low reinfection rates despite data on their outcomes remain limited.

METHODS: A systematic review and metanalysis was conducted following Preferred Reporting Items for Systematic Reviews, and Meta-Analyses and Population, Intervention, and Outcome guidelines using PubMed, Scopus, and Web of Science. Two independent reviewers selected studies, extracted data, and assessed quality. A random-effects meta-analysis was done to evaluate survival, patency, and recurrence. Precision was assessed through 95% confidence intervals (CIs), and publication bias was examined using funnel plots and Egger’s test. The review was registered in International prospective register of systematic reviews (CRD42024629225).

RESULTS: Out of 96 papers screened, 15 studies (300 patients, 81.6% male, mean age 70.5 years) were included. The abdominal aorta was the most frequently treated segment (78.6%), followed by the descending thoracic (9%), thoracoabdominal aorta (6.3%), and ascending/arch (6%). Gram-positive bacteria were the most common pathogens (34.6%) encountered, followed by gram-negative (19%) and fungal infections (10%). Bovine pericardium in situ reconstruction was associated with a 30-day mortality rate of 19.8% (95% CI: 15.0%-25.7%), and an overall mortality of 30.5% (95% CI: 24.2%-37.6%). At a mean follow-up of 18.7 months, reinfection rate was 8.9% and patency rate 92.9%.

CONCLUSION: Bovine grafts show promising midterm results in treatment of aortic infections, assuring good survival and low recurrence rates at the midterm follow-up. Long-term data and comparative studies are needed to confirm their broader applicability.

PMID:41482178 | DOI:10.1016/j.avsg.2025.12.030

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

Colloids Surf B Biointerfaces. 2026 Apr;260:115349. doi: 10.1016/j.colsurfb.2025.115349. Epub 2025 Dec 23.

ABSTRACT

Glutaraldehyde cross-linked bovine/porcine pericardium has been used as prosthetic heart valves (BHVs), while residual aldehyde groups induce cytotoxicity, thrombus formation, and progressive calcification deposition, which ultimately limits instrument life span to 10-15 years. We innovatively designed a multifunctional zwitterionic hydrogel coating copolymer poly (SBMA-co-DMEMAm) on swim bladder-derived material, which is composed of hydrophilic monomer SBMA and aldehyde-containing monomer DMEMAm; besides the aldehyde group can crosslink fish bladder tissue and improve the mechanical properties. This multifunctional hydrophilic polymer coatings provide effective anti-fouling properties, better anti-platelet adsorption and anti-thrombotic properties in in vitro blood compatibility evaluation. In addition, it showed better anti-inflammatory and anti-calcification properties in rat subcutaneous implantation. Thus, this study presents a versatile zwitterionic hydrogel coating strategy that simultaneously endows decellularized swim bladder with superior anti-fouling, hemocompatibility, cytocompatibility, and anti-thrombogenicity, offering a comprehensive solution for durable bioprosthetic heart valves.

PMID:41447863 | DOI:10.1016/j.colsurfb.2025.115349

J Funct Biomater. 2025 Nov 25;16(12):434. doi: 10.3390/jfb16120434.

ABSTRACT

The high incidence of cardiovascular disease and the early failure of bioprosthetic valves due to calcification have driven the development of anti-calcification technologies. As a new storage technology, drying treatment is expected to delay the calcification process by reducing glutaraldehyde residues. However, the effects of drying treatment on the mechanical properties and valve functions of bovine pericardial materials are still unclear. The objective of this study is to evaluate the influence of drying and rehydration treatments on the mechanical integrity and geometric properties of bovine pericardium and the hemodynamic performance of bioprosthetic valves made with these tissues. Cross-linked bovine pericardial samples (n = 15) were divided into three groups-wet (control group progressed with normal glutaraldehyde), dehydrated (ethanol-glycerol dehydration), and rehydration (saline immersion) groups-and the geometric stability and nonlinear mechanical behaviors of the materials were analyzed via thickness measurements and uniaxial and biaxial tensile tests. Quantitative results showed that thickness remained stable across groups (wet: 0.356 ± 0.052 mm; dry: 0.361 ± 0.053 mm; rehydrated: 0.361 ± 0.053 mm, p > 0.05). Elastic modulus values were preserved (wet: 12.5 ± 1.8 MPa; dry: 13.1 ± 2.0 MPa; rehydrated: 12.7 ± 1.9 MPa, p > 0.05), and anisotropy ratio showed no significant changes (1.53 ± 0.06 vs. 1.57 ± 0.07, p > 0.05). The hemodynamic performance of bioprosthetic valves made with these materials was evaluated in vitro using a pulsating flow simulation. Hemodynamic parameters demonstrated excellent preservation: effective orifice area (wet: 2.625 ± 0.11 cm²; rehydrated: 2.585 ± 0.12 cm², Δ = 1.5%, p = 0.32) and regurgitation fraction (wet: 39.35 ± 2.9%; rehydrated: 42.78 ± 3.2%, p = 0.15) showed no statistically significant differences. The geometric properties of the material were not significantly changed by the drying treatment, and the material maintained its nonlinear viscoelastic characteristics and anisotropy. The rehydrated bioprosthetic valves did not differ significantly from those in the wet group in terms of the effective orifice area, regurgitation fraction, and transvalvular pressure difference, and the hemodynamic performance remained stable.

PMID:41440611 | PMC:PMC12734024 | DOI:10.3390/jfb16120434

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

BMC Cardiovasc Disord. 2025 Nov 24;25(1):830. doi: 10.1186/s12872-025-05332-0.

ABSTRACT

BACKGROUND: Purulent pericarditis has become rare in the antibiotic era, particularly when complicated by secondary infections such as an aortic pseudoaneurysm.

CASE PRESENTATION: We report a 46-year-old man who presented with persistent chest pain and cold sweats for three days. Imaging revealed a large pericardial effusion, and cultures grew methicillin-resistant Staphylococcus aureus(MRSA). The patient underwent partial pericardiectomy with delayed sternal closure and open irrigation. On day 23, he developed right shoulder pain, and imaging revealed a pseudoaneurysm of the ascending aorta. Thoracic endovascular aortic repair combined with bovine pericardial patch repair was performed. He survived and remained stable during a 13-month outpatient follow-up.

CONCLUSION: Given the potential for fatal outcomes, clinicians should maintain a high index of suspicion and initiate prompt management, despite the rarity of this complication.

PMID:41286644 | PMC:PMC12642142 | DOI:10.1186/s12872-025-05332-0