Category: General

Klin Monbl Augenheilkd. 2025 Aug 8. doi: 10.1055/a-2670-1917. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to assess the effectiveness of tendon elongation using Tutopatch as a secondary intervention for residual infantile esotropia, particularly in patients exhibiting limited abduction, for whom further conventional surgery might not yield successful outcomes.

METHODS: Design: This retrospective study analyzed data from patients with residual deviation angles following previous surgery for infantile esotropia.

PARTICIPANTS AND INTERVENTION: All patients who underwent tendon elongation with Tutopatch between 2009 and 2023 were included in the study, excluding those with other ocular or strabismus diagnoses or those who refused to participate.

SETTING: The data were collected from patients operated at a single tertiary medical center. The analysis included pre- and postoperative deviation angles recorded at one day, three months, and twelve months, if available. The dose-effect relationship, defined as the deviation angle in degrees per effective operative distance in millimeters, and overall success rates were determined.

PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was the effect of using Tutopatch on the deviation angle. The secondary measure was the effect on ocular motility.

RESULTS: Participants and intervention: The study included twenty-nine patients (ten females, 19 males) with a median age of 17 years (range: 5 – 59 years). The median preoperative deviation angle was +15° (range: +6° to +27°), which decreased to -1.5° (range: -12° to +7°) at the three-month follow-up in 22 patients. Subsequent long-term follow-up in ten patients, after a median duration of 34.5 months (range: 13 to 69 months), revealed a median deviation angle of -1° (range: -15° to +15°). Postoperative adduction was slightly reduced by a median of 5° (range: loss of 30° to gain of 15°). No postoperative complications were observed. Overcorrection necessitated re-operation in five patients, which was uneventful. The median postoperative deviation angle following re-operation was -1° (range: -5° to +8°).

CONCLUSION: Tendon elongation with Tutopatch is effective in managing significant residual infantile esotropia, particularly in complex cases, with minimal impact on duction limitation. Long-term overcorrection may occur, necessitating re-operation that can be performed without difficulty. Zielsetzung: Diese Studie untersucht die Wirksamkeit der Sehnenverlängerung mittels Tutopatch bei residualer frühkindlicher Esotropie, insbesondere bei Patienten*innen mit eingeschränkter Abduktion, bei denen eine konventionelle Nachoperation eventuell nicht erfolgreich wäre.

METHODEN: Studiendesign: Retrospektive Analyse von Patienten*innen mit residualem Schielwinkel nach vorangegangener Operation. Patienten*innen und Intervention: Eingeschlossen wurden alle Patienten*innen, die zwischen 2009 und 2023 eine Sehnenverlängerung mit Tutopatch erhielten. Ausgeschlossen wurden Patienten*innen mit weiteren okulären Diagnosen oder fehlender Einwilligung.

SETTING: Die Datenerhebung erfolgte in einem universitären Zentrum. Analysiert wurden Schielwinkel vor der Operation sowie an Tag 1, nach drei Monaten und – sofern verfügbar – nach zwölf Monaten. Zudem wurde der Dose-Effect (Grad pro mm Operationsstrecke) berechnet und die Erfolgsrate erfasst. Zielparameter: Primärer Endpunkt war die Veränderung des Schielwinkels, sekundärer Endpunkt die Veränderung der okulären Motilität. Ergebnisse: Insgesamt wurden 29 Patienten*innen (10 weiblich, 19 männlich; medianes Alter: 17 Jahre, Spanne: 5–59) eingeschlossen. Der mediane präoperative Schielwinkel betrug +15° und verringerte sich auf -1,5° drei Monate postoperativ (n=22). Die Langzeitnachbeobachtung (n=8, median: 43 Monate) zeigte einen mittleren Schielwinkel von +1°. Die Adduktion war postoperativ median um 5° vermindert (Spanne: -30° bis +15°). Es traten keine Komplikationen auf. Bei fünf Patienten*innen war eine Reoperation wegen Überkorrektur erforderlich; der mediane postoperative Schielwinkel nach Revision betrug -1°. Schlussfolgerung: Die Sehnenverlängerung mit Tutopatch ist bei komplexer residualer frühkindlicher Esotropie wirksam und hat nur geringe Auswirkungen auf die Augenmotilität. Langfristige Überkorrekturen sind möglich, lassen sich jedoch problemlos durch Reoperation korrigieren.

PMID:40780284 | DOI:10.1055/a-2670-1917

J Cardiothorac Surg. 2025 Jun 24;20(1):272. doi: 10.1186/s13019-025-03505-8.

ABSTRACT

OBJECTIVE: To explore the application and effect of aortic annulus reconstruction (AAR) with bovine pericardium during surgical aortic valve replacement (SAVR) for severe calcific aortic stenosis (AS).

METHODS: We retrospectively reviewed 12 patients with severe calcified AS who underwent bovine pericardium aortic annulus reconstruction between January 2021 to December 2023. The average age of the patients was 58 ± 8.8 years. All patients were diagnosed with severe AS, along with aortic valve and annulus calcification, through chest computed tomography (CT) and transthoracic echocardiography (TTE) prior to surgery. After the resection of severely calcified aortic annulus tissue, all patients were given a bovine pericardial patch to repair the annular defect, and five of these patients underwent Y-incision aortic annular enlargement (AAE). The patients were followed up for a duration of 0.5 to 2 years.

RESULTS: A total of 12 patients undergoing SAVR were enrolled, and all received bovine pericardial patches to repair the annular defects, with a mean preoperative indexed effective orifice area (iEOA) of 0.58 ± 0.098 cm²/m². The average extracorporeal circulation time during the operation was 150.83 ± 34.5 min, and the average cross-clamp time was 95.42 ± 17.46 min. Postoperative evaluations indicated that the structural integrity of the valve annulus remained intact, demonstrating hemodynamic stabilization without any recorded fatalities among participants. Compared to preoperative levels, the aortic valve mean gradient (4.67 ± 1.15 vs. 59.67 ± 17.94 mmHg, P < 0.001), peak gradient (13 [10-15.75] vs. 92 [82.25-110.25] mmHg, P < 0.001), mean aortic jet velocity (99.67 ± 15.44 vs. 367.17 ± 58.13 cm/s, P < 0.001), and peak aortic jet velocity (182.25 ± 23.40 vs. 495.67 ± 61.74 cm/s, P < 0.001) significantly decreased after 0.5 years of follow-up. There were no complications such as hemolysis, perivalvular leakage, thrombosis or endocarditis during follow-up.

CONCLUSION: In patients with severe calcified AS, the AAR technique using bovine pericardium during SAVR is safe and effective, with stable hemodynamic performance and satisfactory clinical outcomes.

PMID:40556029 | PMC:PMC12186314 | DOI:10.1186/s13019-025-03505-8

Chem Asian J. 2025 Jul 21:e00652. doi: 10.1002/asia.202500652. Online ahead of print.

ABSTRACT

Bioprosthetic heart valves (BHVs) offer advantages over mechanical valves but are limited by long-term degeneration and calcification. This study aimed to develop a durable BHV material using decellularized bovine pericardium (BP) and alternative cross-linking strategies. BP was decellularized using a combination of sodium deoxycholate (SDC) and Triton X-100 (TX), which removed cellular components while preserving the extracellular matrix (ECM), as confirmed by histological, DNA quantification, and biochemical analyses. The impact of glutaraldehyde, glyoxal, tannic acid, and catechin cross-linking on calcification propensity and mechanical properties was evaluated. Glyoxal-cross-linked BP, further capped with 1% l-glutamic acid, demonstrated superior resistance to calcification while maintaining mechanical properties comparable to standard glutaraldehyde treatment. These results suggest that SDC-TX decellularized, glyoxal-cross-linked BP with l-glutamic acid capping presents a promising strategy for enhancing BHV durability and biocompatibility, offering a potential alternative to conventional glutaraldehyde.

PMID:40686436 | DOI:10.1002/asia.202500652