Type of pledget and suture technique relative to esophageal tensile strength in long-gap esophageal atresia

Pediatr Surg Int. 2026 May 19;42(1):236. doi: 10.1007/s00383-026-06441-3.

ABSTRACT

PURPOSE: We aimed to investigate whether pledget presence, pledget composition, and full versus partial thickness suture technique affect the force esophageal tissue can withstand before tearing.

METHODS: A right thoracotomy was performed on 10 deceased fetal sheep, 110-114 days gestation. The esophagus was divided at the level of the carina and 2 cm of tissue was removed to mimic long-gap esophageal atresia. The pouches were sutured with horizontal mattress non-absorbable braided polyester suture using one of three methods: polytetrafluoroethylene (PTFE) pledgets, bovine pericardial pledgets, or no pledget, in full or partial thickness manner. Each suture was attached to a tensiometer and manually tightened at 50 gram-force / 30 s. Maximal force before esophageal tearing and time to tearing were measured. Results were compared using a linear mixed model.

RESULTS: PTFE pledgets withstood significantly more force than pericardial pledgets (p = 0.029) and provided longer duration before tearing compared to no pledget (p = 0.017) and pericardial pledgets (p = 0.047). Full versus partial-thickness technique made no difference.

CONCLUSION: In a deceased fetal lamb long-gap esophageal atresia model, PTFE pledgets improved tissue resistance to tearing (PTFE > pericardial) and prolonged stretch duration (PTFE > pericardial or no pledget). Suture thickness (full vs. partial) made no difference.

PMID:42154275 | DOI:10.1007/s00383-026-06441-3

Type of pledget and suture technique relative to esophageal tensile strength in long-gap esophageal atresia

Pediatr Surg Int. 2026 May 19;42(1):236. doi: 10.1007/s00383-026-06441-3.

ABSTRACT

PURPOSE: We aimed to investigate whether pledget presence, pledget composition, and full versus partial thickness suture technique affect the force esophageal tissue can withstand before tearing.

METHODS: A right thoracotomy was performed on 10 deceased fetal sheep, 110-114 days gestation. The esophagus was divided at the level of the carina and 2 cm of tissue was removed to mimic long-gap esophageal atresia. The pouches were sutured with horizontal mattress non-absorbable braided polyester suture using one of three methods: polytetrafluoroethylene (PTFE) pledgets, bovine pericardial pledgets, or no pledget, in full or partial thickness manner. Each suture was attached to a tensiometer and manually tightened at 50 gram-force / 30 s. Maximal force before esophageal tearing and time to tearing were measured. Results were compared using a linear mixed model.

RESULTS: PTFE pledgets withstood significantly more force than pericardial pledgets (p = 0.029) and provided longer duration before tearing compared to no pledget (p = 0.017) and pericardial pledgets (p = 0.047). Full versus partial-thickness technique made no difference.

CONCLUSION: In a deceased fetal lamb long-gap esophageal atresia model, PTFE pledgets improved tissue resistance to tearing (PTFE > pericardial) and prolonged stretch duration (PTFE > pericardial or no pledget). Suture thickness (full vs. partial) made no difference.

PMID:42154275 | DOI:10.1007/s00383-026-06441-3

A dual-crosslinking modification strategy as an alternative to glutaraldehyde for preparing valve materials

Int J Biol Macromol. 2026 Jun;367:152551. doi: 10.1016/j.ijbiomac.2026.152551. Epub 2026 May 14.

ABSTRACT

The longevity and applicability of glutaraldehyde cross-linked commercial bioprosthetic heart valves (BHVs) that are the first choice for the transcatheter heart valve replacement (THVR) remain limited due to thrombus accumulation, calcification, inflammatory reactions and poor endothelialization. In this study, we first performed the prefunctionalization treatment of dual crosslinking by carboxymethylated λ-carrageenan and 4-pentenoic acid on decellularized bovine pericardium; subsequently, we conducted a post-functionalization treatment by dual modification of immobilizing the cyclodextrin (CD)/rutin and organic selenium onto above-mentioned doubly cross-linked (DC) bovine pericardium through the amidation reaction; finally, we obtained the anticipated bioprosthetic heart valve with multiple functions (DC + CD/Rutin+Se-BP). Uniaxial tensile tests demonstrated that this doubly cross-linked BHV exhibited superior mechanical properties compared with glutaraldehyde-treated bovine pericardium, which is expected to increase its structural stability and service life. By introducing the CD/Rutin complex and organic selenium, DC + CD/Rutin+Se-BP not only exhibited the ability to inhibit the adsorption of plasma proteins, platelet aggregation and thrombosis but also presented the excellent anti-inflammatory and anti-calcification characteristics both in vitro and in vivo. Furthermore, DC + CD/Rutin+Se-BP also exhibited stable in situ nitric oxide (NO) catalytic release ability due to the immobilization of organic selenium, which endowed bioprosthetic heart valve with excellent compatibility with human umbilical vein endothelial cells (HUVECs) and facilitated the long-term promotion of its endothelialization process. In summary, this approach combining dual cross-linking and dual modification provides a promising strategy for future design of BHVs, and DC + CD/Rutin+Se-BP exhibits a bright prospect in the clinical applications of BHVs.

PMID:42140293 | DOI:10.1016/j.ijbiomac.2026.152551

Successful surgical management of a rare left ventricular pseudoaneurysm following balloon aortic valvuloplasty in an infant

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

Penile Urethral Stricture After Radical Prostatectomy – Use of Aldehyde-Free Bovine Pericardium Graft

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

Penile Urethral Stricture After Radical Prostatectomy – Use of Aldehyde-Free Bovine Pericardium Graft

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

Comparison of physical, mechanical and biological properties of a porcine urinary bladder acellular matrix collagen membrane with six other collagen membranes of animal origin

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

Pericardial patch augmentation with partial ring annuloplasty for rheumatic tricuspid regurgitation

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

Successful surgical management of a rare left ventricular pseudoaneurysm following balloon aortic valvuloplasty in an infant

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

Corrigendum to “Engineering of a bilayer antibacterial wound dressing from bovine pericardium and electrospun chitosan/PVA/antibiotics for infectious skin wounds management: An in vitro and in vivo study” [Int. J. Biol. Macromol. 282 (2024) 137055]

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