Category: General

Urol Ann. 2025 Jul-Sep;17(3):186-191. doi: 10.4103/ua.ua_5_25. Epub 2025 Jul 18.

ABSTRACT

AIMS: The plaque excision and grating technique is indicated for correcting penile curvature in Peyronie’s disease. We assessed our experience of the modified split graft technique using bovine pericardium after plaque excision.

MATERIALS AND METHODS: Between March 2020 and September 2024, we operated on 12 patients by the excision of plaque and split grafting technique. Here, we discuss our experience customizing a bovine pericardium graft on a table according to the size of the defect and joining pieces of graft and tunica albuginea with a Polydioxanone (PDS) suture to cover the cavernosal defect.

RESULTS: Patients’ mean age and follow-up were 48 years and 30 months, respectively. The average size of the plaque and penile curvature was 4.6 cm (range 1.5-8 cm) and 45°, respectively. No residual penile curvature was observed in 83.5% of patients while (16.5%) had curvature of <20°. All patients experienced an improvement in stretched penile length with an average increase of 1.6 cm. Seventy-five percent of patients were able to perform sexual activity without assistance after 3 months. One patient, who had a sizeable cavernosal defect of 8 cm × 2 cm, experienced severe postoperative erectile dysfunction (ED) along with residual penile curvature of 15° and required semi-rigid penile prosthesis. Two patients having mild ED was managed by Tadalafil 10 mg. Another patient with residual chordee of <20° was managed on conservative therapy.

CONCLUSIONS: In our limited experience, this modified split graft technique using bovine pericardium after plaque excision seems feasible, cost-effective, and safe. It has comparable outcomes to the standard methods reported in the literature and reduces graft material wastage. Further, long-term randomized trials are needed to validate its long-term efficacy and safety compared to conventional grafting approaches.

PMID:40843398 | PMC:PMC12366843 | DOI:10.4103/ua.ua_5_25

Adv Mater. 2025 Aug 5:e2504765. doi: 10.1002/adma.202504765. Online ahead of print.

ABSTRACT

Cardiac patches to repair myocardial defects require mechanically stable materials that prevent bleeding and can be implanted via suturing. The current clinical standard, bovine pericardial patches (BPPs), serve this purpose but do not degrade or integrate with the myocardium, limiting their long-term effectiveness. Here, we present the reinforced cardiac tissue patch (RCPatch). This multimaterial patch comprises a stiffness-tuned, cardiomyocyte-infiltrated 3D metamaterial and a suturable, hydrogel-infiltrated mesh to reduce permeability and bleeding. Anisotropic metamaterials are designed and computationally optimized using a generative modeling approach and fabricated from poly(ε-caprolactone) (PCL) via volumetric 3D printing (VP). The metamaterial supports the infiltration of cardiomyocytes, which are viable and contract in vitro. The implantability and low blood permeability of the patch is enabled by adding a melt-electrowritten (MEW) mesh infiltrated with a fibrin hydrogel. In an acute large animal trial, the RCPatch was applied on an induced myocardial defect, where it withstood intraventricular blood pressure, prevented bleeding, and enabled hemodynamic restabilization (intraventricular pressure of 81 mmHg before, vs 66 mmHg after implantation). These findings establish a scalable framework for fabricating cardiac tissue patches that integrate mechanical reinforcement with biological function, offering a surgically implantable and future regenerative solution for intraventricular myocardial repair.

PMID:40761175 | DOI:10.1002/adma.202504765

J Cardiovasc Surg (Torino). 2025 Aug;66(4):291-298. doi: 10.23736/S0021-9509.25.13336-3.

ABSTRACT

BACKGROUND: Aortic Graft Infection (AGI) and Infective Native Aortic Aneurysm (INAA) require open repair with infection-resistant prostheses. Physician’s made xeno-pericardial grafts combine availability with freedom from reinfection, but mainly short-term results are reported. The aim is to examine the mid-term outcomes in aortic infections using stapled physician-made or pre-sutured bovine pericardium tube grafts.

METHODS: We report all patients who underwent in situ aortic reconstruction using pericardial tube grafts (prepared from pericardial patches using a surgical stapler or pre-sutured) for AGI or INAA between January 2019 and October 2024 at a single center. Perioperative outcomes and follow-up data were retrospectively collected.

RESULTS: Twenty-one patients (18 male, median age 72 years) underwent aortic surgery and implantation of a preformed (N.=5) or stapled physician-made (N.=16) pericardial tubes graft for an INAA (N.=7) or AGI (N.=14). All AGI patients had late infections (median time from primary surgery of 81 months), in nine cases associated with aorto-digestive fistula. One perioperative death was recorded. Patients treated for an AGI demonstrated a longer median length of stay (22 vs. 12 days; P=0.020) and higher intraoperative blood loss (1400 vs. 400 mL; P=0.025). Of the 20 patients surviving the index event, at a mean follow-up of 23±8 months, no aortic-related death, nor mechanical failure were recorded. One case of reinfection and reintervention has been observed (4.8%). All but one patient discontinued the antibiotic therapy after a median duration of 146 days.

CONCLUSIONS: Aortic repair with preformed and home-made stapled xeno-pericardial grafts is safe and provides durable infection-free survival at a mid-term follow-up.

PMID:40985629 | DOI:10.23736/S0021-9509.25.13336-3

Vasc Specialist Int. 2025 Jul 31;41:18. doi: 10.5758/vsi.250027.

ABSTRACT

PURPOSE: This study retrospectively evaluated the mid-term outcomes of thromboendarterectomy (TEA) for common femoral artery (CFA) disease in a Japanese cohort by comparing patients with chronic limb-threatening ischemia (CLTI) and intermittent claudication (IC).

MATERIALS AND METHODS: Sixty-three TEA procedures performed between 2011 and 2024 were analyzed. The primary endpoints focused on procedure-related outcomes such as patency and limb salvage, whereas overall survival was assessed as a key secondary outcome. The patients were divided into the CLTI (n=20) and IC (n=43) groups; the anesthesia type, additional revascularization, blood loss, hospital stay, complications, and survival were compared. Multivariable Cox regression analysis was performed to identify independent predictors of mortality.

RESULTS: Patients with CLTI had higher rates of local anesthesia, additional revascularization (all performed concomitantly), greater blood loss, and longer hospital stays. Despite the 100% technical success in both groups, 30-day mortality and complications occurred only in the CLTI group. Kaplan-Meier analysis showed similar patency and limb salvage rates between groups, whereas survival rates were significantly lower in patients with CLTI (P=0.037). Multivariable analysis revealed that CLTI itself was not an independent predictor of mortality; rather, a worse systemic status (e.g., higher American Society of Anesthesiologists classification) showed a trend toward poorer outcomes (P=0.051). No significant differences were found between the patch types.

CONCLUSION: TEA provides effective mid-term outcomes in patients with CFA disease, particularly those with IC. Although patients with CLTI show poorer survival, this appears to be driven more by systemic comorbidities than by the limb status itself. Careful preoperative assessment and holistic management of general health are essential to optimize outcomes, particularly in high-risk populations.

PMID:40739708 | PMC:PMC12311306 | DOI:10.5758/vsi.250027