Category: General

BMJ Case Rep. 2026 Mar 25;19(3):e272043. doi: 10.1136/bcr-2026-272043.

ABSTRACT

We report the case of a man in his mid 70s with a history of coronary artery bypass grafting and prior surgical repair of an ascending aortic pseudoaneurysm using a bovine pericardial patch. He was subsequently found to have a persistent pseudoaneurysm adjacent to the right coronary ostium. In view of his prior sternotomy and the close proximity of the lesion to the coronary ostium, a transcatheter approach was selected. The pseudoaneurysm was successfully excluded using a duct occluder device, followed by deployment of a covered Papyrus coronary stent to reinforce the neck seal while preserving coronary flow. This case underscores the importance of multimodality imaging for diagnosis and procedural planning in complex, high-risk patients and demonstrates the feasibility of a dual-device transcatheter strategy for managing persistent aortic pseudoaneurysms in anatomically challenging locations.

PMID:41881477 | DOI:10.1136/bcr-2026-272043

Eur J Cardiothorac Surg. 2026 Mar 10;68(3):ezag097. doi: 10.1093/ejcts/ezag097.

ABSTRACT

OBJECTIVES: The availability and affordability of conduits have significantly challenged congenital heart surgery in low-resource settings. We present the intermediate-term outcomes of low-cost customized handmade conduits at our institution.

METHODS: Analysis of our surgical database and hospital information system (2016-2023) was done. Handmade conduits (cost: 30% of commercial conduits) were prepared in the operating room prior to surgery, using bovine pericardium for the conduit body tailored to the exact required diameter, with 0.1 mm polytetrafluoroethylene (PTFE) valve leaflets.

RESULTS: Handmade conduits were implanted in 185 patients [median age: 1.58 years (0.75-6.92), weight: 8.40 kg (6.30-17.03); conduit diameter 15 mm (13-20); cardiopulmonary bypass time 191.5 minutes (160-238) and cross-clamp time 106.5 minutes (73.8-145)]. Median ventilation duration was 19 hours (7-39), intensive care unit (ICU) stay 72 hours (44-120), and hospital stay 15 days (IQR: 11-20); mortality was 3.8%. The median follow-up duration was 29.5 months (14-59.5) for 160 patients. Peak conduit gradient on follow-up was 40 mm Hg (IQR: 22.8-63.8). Significant conduit regurgitation was noted in 21.2%. Endocarditis occurred in 7 (4.3%) patients (late in 4, early in 3). Re-interventions included 22 transcatheter procedures [18 balloon, 4 stents] at a median of 24 (12.2-34.7) months from conduit implantation. Of the 160 patients on follow-up, 28 had their conduits replaced at a median of 37 months (21-65 months) from implantation. Freedom from the composite end-point of reintervention/reoperation/death was 94% at 1 year; 70% at 5 years.

CONCLUSIONS: Handmade pericardial valved conduits are a potentially attractive low-cost alternative to commercially available conduits in low-resource settings.

PMID:41701157 | DOI:10.1093/ejcts/ezag097

Eur J Cardiothorac Surg. 2026 Mar 10;68(3):ezag097. doi: 10.1093/ejcts/ezag097.

ABSTRACT

OBJECTIVES: The availability and affordability of conduits have significantly challenged congenital heart surgery in low-resource settings. We present the intermediate-term outcomes of low-cost customized handmade conduits at our institution.

METHODS: Analysis of our surgical database and hospital information system (2016-2023) was done. Handmade conduits (cost: 30% of commercial conduits) were prepared in the operating room prior to surgery, using bovine pericardium for the conduit body tailored to the exact required diameter, with 0.1 mm polytetrafluoroethylene (PTFE) valve leaflets.

RESULTS: Handmade conduits were implanted in 185 patients [median age: 1.58 years (0.75-6.92), weight: 8.40 kg (6.30-17.03); conduit diameter 15 mm (13-20); cardiopulmonary bypass time 191.5 minutes (160-238) and cross-clamp time 106.5 minutes (73.8-145)]. Median ventilation duration was 19 hours (7-39), intensive care unit (ICU) stay 72 hours (44-120), and hospital stay 15 days (IQR: 11-20); mortality was 3.8%. The median follow-up duration was 29.5 months (14-59.5) for 160 patients. Peak conduit gradient on follow-up was 40 mm Hg (IQR: 22.8-63.8). Significant conduit regurgitation was noted in 21.2%. Endocarditis occurred in 7 (4.3%) patients (late in 4, early in 3). Re-interventions included 22 transcatheter procedures [18 balloon, 4 stents] at a median of 24 (12.2-34.7) months from conduit implantation. Of the 160 patients on follow-up, 28 had their conduits replaced at a median of 37 months (21-65 months) from implantation. Freedom from the composite end-point of reintervention/reoperation/death was 94% at 1 year; 70% at 5 years.

CONCLUSIONS: Handmade pericardial valved conduits are a potentially attractive low-cost alternative to commercially available conduits in low-resource settings.

PMID:41701157 | DOI:10.1093/ejcts/ezag097

JACC Case Rep. 2026 Jan 28;31(4):106139. doi: 10.1016/j.jaccas.2025.106139.

ABSTRACT

BACKGROUND: Septic pseudoaneurysms of the native ascending aorta are rare and challenging to treat, especially in elderly, comorbid patients with septic conditions and unfavorable anatomy for endovascular repair.

CASE SUMMARY: A 78-year-old man with prior tricuspid valve replacement for endocarditis presented with methicillin-sensitive Staphylococcus aureus bacteremia. Imaging showed a large ascending aorta pseudoaneurysm, likely at the previous cardioplegia site. He underwent successful surgical repair via direct bovine pericardial patch closure under normothermic cardiopulmonary bypass. Recovery was uneventful.

DISCUSSION: Endovascular repair requires suitable anatomy, including adequate landing zones and small neck size, which were lacking here. Direct surgical patch repair offers a safe, effective, and less-invasive alternative to full aortic replacement, especially in septic, frail patients.

TAKE-HOME MESSAGES: Multidisciplinary heart team discussion is essential to tailor management for complex septic aortic pseudoaneurysms. When endovascular treatment is unfeasible, direct surgical patch repair remains a safe and effective option in selected patients.

PMID:41609270 | PMC:PMC12882324 | DOI:10.1016/j.jaccas.2025.106139

Biochem Biophys Rep. 2026 Feb 6;45:102490. doi: 10.1016/j.bbrep.2026.102490. eCollection 2026 Mar.

ABSTRACT

This study explores the bioactive potential of bovine pericardium membranes combined with hyaluronic acid (HA, 120 kDa) at concentrations of .5%, 1.0%, and 2.0% through physicochemical characterization and fibroblast cell viability analysis. A laboratory experimental design was employed to evaluate bovine pericardium membranes modified with hyaluronic acid at different concentrations. Material characterization was conducted employing Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM), and X-ray Diffraction (XRD) analyses. Fibroblast cell viability was assessed using the MTT assay, and statistical analysis was conducted using the ANOVA test. The results demonstrated that hyaluronic acid modification altered the physicochemical characteristics of the membrane, including increased surface hydrophilicity. The cell viability test revealed comparable fibroblast viability among HA-modified membranes, indicating no cytotoxic effects. FTIR and SEM analyses confirmed chemical interactions and morphological features associated with favorable cell-material interactions. These findings suggest that bovine pericardium membrane with hyaluronic acid 120 kDa exhibit favorable physicochemical characteristics and in vitro cytocompatibility, indicating their potential for tissue engineering applications. This research provides a scientific foundation for developing innovative biomaterials that support favorable cell-material interactions for tissue regeneration research, contributing to advancements in tissue regeneration therapy.

PMID:41694670 | PMC:PMC12905706 | DOI:10.1016/j.bbrep.2026.102490

Am J Case Rep. 2026 Mar 19;27:e950059. doi: 10.12659/AJCR.950059.

ABSTRACT

BACKGROUND Pseudoaneurysms of the sinus of Valsalva (SOV) are rare and potentially life-threatening. Simultaneous pseudoaneurysms involving multiple sinuses and the ascending aorta are extremely uncommon. These lesions can exert a mass effect on adjacent cardiac structures, leading to valve dysfunction and heart failure. CASE REPORT We present the case of a 35-year-old man who was referred with progressive dyspnea and signs of heart failure. Although a prior febrile illness raised suspicion for an infectious etiology, the definitive cause remained indeterminate due to negative microbiological and serological workup. Initial imaging suggested an aortic dissection; however, further evaluation revealed large pseudoaneurysms in the left and right sinuses of Valsalva and the ascending aorta. Severe mitral regurgitation was noted, attributed to extrinsic annular distortion from the large left SOV pseudoaneurysm. The patient underwent urgent surgical intervention, including closure of the left and right SOV pseudoaneurysm orifices with bovine pericardial patches, excision of the ascending aortic pseudoaneurysm, and mitral valve annuloplasty using a 30-mm Carpentier-Edwards Physio II ring. The aorta was reconstructed without the need for a prosthetic graft. Postoperative recovery was uneventful, and the patient was discharged on postoperative day 10. CONCLUSIONS This case illustrates a rare constellation of multiple SOV pseudoaneurysms. Crucially, it highlights the mechanistic link between the pseudoaneurysm’s mass effect and functional mitral regurgitation. Timely surgical management corrected the anatomical defects and restored hemodynamic function. Awareness of such unusual presentations is essential for accurate diagnosis and prompt intervention.

PMID:41855135 | PMC:PMC13011654 | DOI:10.12659/AJCR.950059

Gen Thorac Cardiovasc Surg Cases. 2026 Jan 16;5(1):4. doi: 10.1186/s44215-025-00239-w.

ABSTRACT

BACKGROUND: Cardiac hemangiomas located in the right heart can lead to serious complications, including right ventricular outflow tract (RVOT) obstruction, arrhythmias, and sudden cardiac death. Although surgical resection remains the primary treatment, complete excision of intramural tumors poses risk of impairing cardiac function. This case report describes the successful resection of a large right ventricular hemangioma using intraoperative voltage mapping, which enable maximal tumor removal while preserving myocardial integrity and preventing postoperative heart failure.

CASE PRESENTATION: A 76-year-old female underwent a routine health examination in July 2024, during which cardiomegaly and nonspecific ST-segment changes were detected on electrocardiography. Contrast enhanced computed tomography revealed a well-defined 60 mm mass within the right ventricle, causing significant ROVT stenosis. No evidence of distant metastasis or elevated tumor markers was detected. The patient underwent tumor resection via median sternotomy. Intraoperative voltage mapping was utilized to delineate viable myocardium at the tumor margins. The tumor was excised while preserving functional myocardial tissue. Cryoablation was performed at the resection margins, and resultant defect in the right ventricular wall was reconstructed using a bovine pericardial patch. Histopathological analysis confirmed the diagnosis of cardiac hemangioma. The patient experienced an uneventful postoperative course had no postoperative complications and was discharged on postoperative day 16. Preoperative and postoperative cardiac magnetic resonance imaging demonstrated preserved right ventricular function.

CONCLUSIONS: Intraoperative voltage mapping proved to be a valuable adjunct in the surgical management of right ventricular tumors, enabling effective tumor resection while preserving myocardial tissue and maintaining postoperative cardiac function.

PMID:41546056 | PMC:PMC12896158 | DOI:10.1186/s44215-025-00239-w

Biochem Biophys Rep. 2026 Feb 6;45:102490. doi: 10.1016/j.bbrep.2026.102490. eCollection 2026 Mar.

ABSTRACT

This study explores the bioactive potential of bovine pericardium membranes combined with hyaluronic acid (HA, 120 kDa) at concentrations of .5%, 1.0%, and 2.0% through physicochemical characterization and fibroblast cell viability analysis. A laboratory experimental design was employed to evaluate bovine pericardium membranes modified with hyaluronic acid at different concentrations. Material characterization was conducted employing Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM), and X-ray Diffraction (XRD) analyses. Fibroblast cell viability was assessed using the MTT assay, and statistical analysis was conducted using the ANOVA test. The results demonstrated that hyaluronic acid modification altered the physicochemical characteristics of the membrane, including increased surface hydrophilicity. The cell viability test revealed comparable fibroblast viability among HA-modified membranes, indicating no cytotoxic effects. FTIR and SEM analyses confirmed chemical interactions and morphological features associated with favorable cell-material interactions. These findings suggest that bovine pericardium membrane with hyaluronic acid 120 kDa exhibit favorable physicochemical characteristics and in vitro cytocompatibility, indicating their potential for tissue engineering applications. This research provides a scientific foundation for developing innovative biomaterials that support favorable cell-material interactions for tissue regeneration research, contributing to advancements in tissue regeneration therapy.

PMID:41694670 | PMC:PMC12905706 | DOI:10.1016/j.bbrep.2026.102490

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