Category: General

Biomed Mater. 2026 Jul 10. doi: 10.1088/1748-605X/ae8945. Online ahead of print.

ABSTRACT

At present, most biological valves used for clinical application are created using glutaraldehyde (GLUT) cross-linked animal pericardia or aortic valve materials. Since GLUT cannot cross-link with elastin, which would be further degraded and absorbed by the body after being implanted into the body, structural damage and calcification of biological valves can occur. In this study, we proposed a new elastin cross-linking agent, dihydromyricetin (DMY). We evaluated the characteristics of DMY in different treatment groups and in rat animal models. Using circular dichroism (CD), Fourier transform infrared spectroscopy and nuclear magnetic resonance hydrogen spectroscopy, we confirmed that DMY can cross-link with elastin and then enhances its anti-elastase hydrolysis ability with the bovine pericardium (BP) and internal mammary artery (IMA). The subcutaneous implantation of young rats confirmed that the addition of DMY on samples reduced the calcification degree of GLUT cross-linked BP by nearly 40%, and the implanted pericardial elastin component remained stable after 8 weeks. In summary, DMY can fix the components of BP elastin without affecting the mechanical strength of GLUT-cross-linked valve materials, proving that it is a safe and stable elastin cross-linking agent.

PMID:42431207 | DOI:10.1088/1748-605X/ae8945

JACC Case Rep. 2026 Jul 24:109447. doi: 10.1016/j.jaccas.2026.109447. Online ahead of print.

ABSTRACT

BACKGROUND: Pseudoaneurysm of the ascending aorta is a rare but potentially fatal complication post cardiac surgery, often linked to infection.

CASE SUMMARY: A 59-year-old woman presented 4 months post coronary artery bypass graft surgery with fatigue, fever, and acute coronary syndrome. Urgent computed tomography revealed a 31-mm anterior pseudoaneurysm at the occluded radial artery graft origin, with perianeurysmal inflammation and sternal osteomyelitis. She underwent urgent resection and bovine pericardial patch repair, followed by 6 weeks of intravenous antibiotics.

DISCUSSION: Post-coronary artery bypass graft aortic pseudoaneurysms typically arise at graft or cannulation sites and may be mycotic. This case highlights a rare mechanism in which proximal anastomotic disruption caused early radial artery graft failure resulting in acute coronary syndrome. Allografts or bovine conduits are preferred for repair to minimize the risk of recurrent infection.

TAKE-HOME MESSAGES: Mycotic pseudoaneurysm should be suspected in patients with unexplained symptoms after cardiac surgery. Computed tomography plays a vital role in diagnosis, infection extent, surgical planning, and postoperative surveillance of recurrence.

PMID:42501031 | DOI:10.1016/j.jaccas.2026.109447

Biomed Mater. 2026 Jul 10. doi: 10.1088/1748-605X/ae8945. Online ahead of print.

ABSTRACT

At present, most biological valves used for clinical application are created using glutaraldehyde (GLUT) cross-linked animal pericardia or aortic valve materials. Since GLUT cannot cross-link with elastin, which would be further degraded and absorbed by the body after being implanted into the body, structural damage and calcification of biological valves can occur. In this study, we proposed a new elastin cross-linking agent, dihydromyricetin (DMY). We evaluated the characteristics of DMY in different treatment groups and in rat animal models. Using circular dichroism (CD), Fourier transform infrared spectroscopy and nuclear magnetic resonance hydrogen spectroscopy, we confirmed that DMY can cross-link with elastin and then enhances its anti-elastase hydrolysis ability with the bovine pericardium (BP) and internal mammary artery (IMA). The subcutaneous implantation of young rats confirmed that the addition of DMY on samples reduced the calcification degree of GLUT cross-linked BP by nearly 40%, and the implanted pericardial elastin component remained stable after 8 weeks. In summary, DMY can fix the components of BP elastin without affecting the mechanical strength of GLUT-cross-linked valve materials, proving that it is a safe and stable elastin cross-linking agent.

PMID:42431207 | DOI:10.1088/1748-605X/ae8945

JACC Case Rep. 2026 Jul 24:109447. doi: 10.1016/j.jaccas.2026.109447. Online ahead of print.

ABSTRACT

BACKGROUND: Pseudoaneurysm of the ascending aorta is a rare but potentially fatal complication post cardiac surgery, often linked to infection.

CASE SUMMARY: A 59-year-old woman presented 4 months post coronary artery bypass graft surgery with fatigue, fever, and acute coronary syndrome. Urgent computed tomography revealed a 31-mm anterior pseudoaneurysm at the occluded radial artery graft origin, with perianeurysmal inflammation and sternal osteomyelitis. She underwent urgent resection and bovine pericardial patch repair, followed by 6 weeks of intravenous antibiotics.

DISCUSSION: Post-coronary artery bypass graft aortic pseudoaneurysms typically arise at graft or cannulation sites and may be mycotic. This case highlights a rare mechanism in which proximal anastomotic disruption caused early radial artery graft failure resulting in acute coronary syndrome. Allografts or bovine conduits are preferred for repair to minimize the risk of recurrent infection.

TAKE-HOME MESSAGES: Mycotic pseudoaneurysm should be suspected in patients with unexplained symptoms after cardiac surgery. Computed tomography plays a vital role in diagnosis, infection extent, surgical planning, and postoperative surveillance of recurrence.

PMID:42501031 | DOI:10.1016/j.jaccas.2026.109447

Eur Heart J Case Rep. 2026 Jul 16;10(7):ytag490. doi: 10.1093/ehjcr/ytag490. eCollection 2026 Jul.

ABSTRACT

BACKGROUND: Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder associated with aortic aneurysms and increased surgical complications. Recognizing left ventricular outflow tract (LVOT) pseudoaneurysm after aortic root surgery is challenging but is essential given rupture risk.

CASE SUMMARY: A 20-year-old woman with genetically confirmed LDS (TGFBR2-related) and history of elective valve-sparing aortic root replacement for a 4.3 cm aortic aneurysm presented with progressive substernal chest pain and dyspnoea. Transthoracic echocardiography revealed a giant LVOT pseudoaneurysm and mildly reduced left ventricular systolic function. Chest CT angiography confirmed the diagnosis and defined its extent. She underwent urgent surgical repair using a bovine pericardial patch with intraoperative finding of suture-line dehiscence at the aorto-mitral intervalvular fibrosa. Four weeks after redo cardiac surgery, she was found to be 7 weeks pregnant and, after counselling regarding her extremely high-risk status, opted to continue the pregnancy.

DISCUSSION: This case illustrates the complexities of surgical intervention in LDS, where tissue fragility and comorbidities increase perioperative risk and complicate management. Close postoperative TTE may enable early detection of LVOT pseudoaneurysm after aortic surgery. A low threshold for chest CTA is key for distinguishing true from pseudoaneurysm. Shorter surveillance intervals may be warranted in high-risk patients with risk factors such as tissue fragility, complicated postoperative course, or chest wall deformity.

PMID:42483704 | PMC:PMC13387059 | DOI:10.1093/ehjcr/ytag490

ANZ J Surg. 2026 Jul 6. doi: 10.1111/ans.70833. Online ahead of print.

ABSTRACT

BACKGROUND: Bovine pericardium (BP) is increasingly utilised in complex surgical reconstruction because of its favourable biological and mechanical properties. Although widely used in cardiovascular surgery, its role in general surgery remains less well characterised.

METHODS: A narrative review was conducted to synthesise available evidence regarding the biological properties, preparation methods, tissue integration and clinical applications of BP in general surgery.

RESULTS: BP demonstrates favourable tensile strength, low antigenicity, and reliable biocompatibility. Available evidence, largely from observational studies and small case series, supports its use across a variety of general and subspecialty surgical settings including vena cava and portal vein reconstruction, diaphragmatic hernia repair, abdominal wall reconstruction, and arteriovenous fistula formation. Compared with synthetic grafts, BP may offer advantages in contaminated or infected fields, although comparative data is limited. Tissue integration varies according to preparation technique, with decellularised grafts demonstrating improved cellular infiltration and reduced calcification. Novel applications, including reconstructing the empty pelvis after exenteration, are emerging.

CONCLUSION: BP is a durable and individually adaptable biomaterial with expanding applications in general surgery. Its favourable handling characteristics and biological integration make it a valuable adjunct in complex reconstructions, although further studies are required to better define its long-term outcomes and comparative effectiveness.

PMID:42409595 | DOI:10.1111/ans.70833

J Cardiothorac Surg. 2026 Jul 19. doi: 10.1186/s13019-026-04610-y. Online ahead of print.

ABSTRACT

Aberrant right subclavian artery (ARSA) is the most common anomaly of the aortic arch and is usually asymptomatic. In a minority of patients, ARSA may cause dysphagia due to esophageal compression (dysphagia lusoria). The coexistence of symptomatic ARSA and severe aortic stenosis requiring surgical treatment is extremely rare, and the optimal management strategy remains unclear. A 43-year-old woman presenting with acute decompensated heart failure was diagnosed with severe aortic stenosis and concomitant dysphagia lusoria. Following medical stabilization in the intensive care unit, she underwent a single-stage total correction. To minimize surgical trauma and avoid multiple incisions, a conventional median sternotomy was slightly extended into the right supraclavicular region, serving as a single unified incision. Through this approach, transposition of the ARSA to the right common carotid artery was performed first, followed by mechanical aortic valve replacement with bovine pericardial patch repair of a focal annular defect secondary to decalcification and primary closure of a patent foramen ovale. Postoperatively, valve hemodynamics improved markedly, and dysphagia resolved completely, leading to a significant recovery of the patient’s nutritional status. This case demonstrates that a single-stage, single-incision approach is a highly effective and viable strategy, providing valuable clinical insight into the management of these combined rare pathologies.

PMID:42472844 | DOI:10.1186/s13019-026-04610-y

Plast Aesthet Nurs (Phila). 2026 Jul-Sep 01;46(3):147-152. doi: 10.1097/PSN.0000000000000673.

ABSTRACT

The increasing number of younger patients requiring cardiac implantable electronic devices (CIEDs) necessitates not only survival but also a preserved quality of life. Aesthetic considerations for CIED placement-particularly in the context of the female breast-are increasingly important, yet current guidelines lack standardized recommendations for ideal generator pocket positioning, especially in the presence of breast implants. We report the first use of bovine pericardium mesh to reposition a migrated, protruding subcutaneous CIED in a patient with prior breast implant reconstruction, who presented with breast contour distortion. Generator pocket repositioning was performed using an acellular biological matrix (ABM) to anchor the device securely against the prepectoral fascia, effectively preventing future dislodgement. The patient achieved excellent breast symmetry and a smooth transition between the anterior chest wall and the superolateral mammary pole. Postoperative ultrasonography confirmed successful compartmentalization of the periprosthetic space, matrix, and device. Durable device positioning was maintained at 12-month follow-up. This case demonstrates that reinforcement and repositioning of subcutaneous CIEDs using ABM in patients with breast implants offers multiple advantages including minimized tissue disruption; stable positioning along the chest wall; isolation of the periprosthetic space; and aesthetic outcomes comparable to those achieved with deeper device placement.

PMID:42390052 | DOI:10.1097/PSN.0000000000000673

Plast Aesthet Nurs (Phila). 2026 Jul-Sep 01;46(3):147-152. doi: 10.1097/PSN.0000000000000673.

ABSTRACT

The increasing number of younger patients requiring cardiac implantable electronic devices (CIEDs) necessitates not only survival but also a preserved quality of life. Aesthetic considerations for CIED placement-particularly in the context of the female breast-are increasingly important, yet current guidelines lack standardized recommendations for ideal generator pocket positioning, especially in the presence of breast implants. We report the first use of bovine pericardium mesh to reposition a migrated, protruding subcutaneous CIED in a patient with prior breast implant reconstruction, who presented with breast contour distortion. Generator pocket repositioning was performed using an acellular biological matrix (ABM) to anchor the device securely against the prepectoral fascia, effectively preventing future dislodgement. The patient achieved excellent breast symmetry and a smooth transition between the anterior chest wall and the superolateral mammary pole. Postoperative ultrasonography confirmed successful compartmentalization of the periprosthetic space, matrix, and device. Durable device positioning was maintained at 12-month follow-up. This case demonstrates that reinforcement and repositioning of subcutaneous CIEDs using ABM in patients with breast implants offers multiple advantages including minimized tissue disruption; stable positioning along the chest wall; isolation of the periprosthetic space; and aesthetic outcomes comparable to those achieved with deeper device placement.

PMID:42390052 | DOI:10.1097/PSN.0000000000000673

Plast Aesthet Nurs (Phila). 2026 Jul-Sep 01;46(3):147-152. doi: 10.1097/PSN.0000000000000673.

ABSTRACT

The increasing number of younger patients requiring cardiac implantable electronic devices (CIEDs) necessitates not only survival but also a preserved quality of life. Aesthetic considerations for CIED placement-particularly in the context of the female breast-are increasingly important, yet current guidelines lack standardized recommendations for ideal generator pocket positioning, especially in the presence of breast implants. We report the first use of bovine pericardium mesh to reposition a migrated, protruding subcutaneous CIED in a patient with prior breast implant reconstruction, who presented with breast contour distortion. Generator pocket repositioning was performed using an acellular biological matrix (ABM) to anchor the device securely against the prepectoral fascia, effectively preventing future dislodgement. The patient achieved excellent breast symmetry and a smooth transition between the anterior chest wall and the superolateral mammary pole. Postoperative ultrasonography confirmed successful compartmentalization of the periprosthetic space, matrix, and device. Durable device positioning was maintained at 12-month follow-up. This case demonstrates that reinforcement and repositioning of subcutaneous CIEDs using ABM in patients with breast implants offers multiple advantages including minimized tissue disruption; stable positioning along the chest wall; isolation of the periprosthetic space; and aesthetic outcomes comparable to those achieved with deeper device placement.

PMID:42390052 | DOI:10.1097/PSN.0000000000000673