Category: General

Interdiscip Cardiovasc Thorac Surg. 2025 Nov 6;40(11):ivaf236. doi: 10.1093/icvts/ivaf236.

ABSTRACT

OBJECTIVES: Although rare, aorto-oesophageal fistula remains one of the most critical diseases in cardiovascular surgery. The lack of prospective studies or large case series leads to an absence of evidence-based therapeutic concepts.

METHODS: We conducted a retrospective analysis of patients treated for aorto-oesophageal fistula between 2014 and 2023. Primary endpoints of analysis were 30-day mortality and median survival; subgroup analysis was performed for aetiology as well as treatment strategy. Additionally, a systematic search was conducted for all studies researching treatment of the disease, including ≥5 patients and published within the last 10 years.

RESULTS: In the collective of 10 patients, 4 manifested as primary fistula, while in 6 patients the fistula occurred secondary to previous thoracic endovascular aortic repair. Median duration to manifestation post-TEVAR was 20.1 months (34.1). Initial treatment consisted of TEVAR or TEVAR-relining in 7 cases, followed by bovine open aortic replacement (n = 1) or partial bovine patch repair (n = 2) when viable. Treatment of the oesophagus consisted of primary suture (n = 1) or oesophagectomy (n = 5) with gastric pull-up or colon interposition. Overall 30-day mortality was 40%, and overall median survival was 7.5 months (12.8). Patients receiving surgical treatment of the oesophagus exhibited longer survival than patients who did not (12.8 months [4.7] vs 0.35 months [0.4]). Across the reviewed literature, the strongest effect on survival originates from surgical treatment of the oesophagus. Specific surgical strategies as well as patient characteristics vary widely.

CONCLUSIONS: We found TEVAR effective in stabilizing the initial haemorrhage. Short-interval oesophagectomy seems to improve survival and should be considered in most patients. Open aortic replacement with bovine pericardium is a viable option. Interventional treatment options alone do not appear to be sufficient.

PMID:41105160 | PMC:PMC12622961 | DOI:10.1093/icvts/ivaf236

Artif Organs. 2025 Oct 13. doi: 10.1111/aor.70028. Online ahead of print.

ABSTRACT

BACKGROUND: Heart valve diseases remain a leading cause of death in industrialized nations. Polycarbonate urethane (PCU) is a promising material for heart valve prostheses due to its biocompatibility and low calcification tendency. However, the impact of processing methods on calcification remains unclear.

METHODS: PCU patches were fabricated via hot pressing or solution casting. Both groups (n = 3 each), along with bovine pericardium patches as positive controls (n = 3), were incubated for 10 weeks in a custom in vitro calcification fluid. Calcification, cytocompatibility, and material properties were assessed using light and electron microscopy, infrared spectroscopy, and gel permeation chromatography (GPC).

RESULTS: Calcification was observed in hot-pressed PCU and control patches but not in solution-cast PCU. Both PCU types showed comparable cytocompatibility. Spectroscopy and GPC revealed chemical and structural changes in hot-pressed PCU, likely promoting calcification.

CONCLUSION: Hot pressing alters the chemical structure of PCU and increases its calcification propensity without affecting cytocompatibility. These findings highlight the importance of process control and in vitro screening during heart valve material development.

PMID:41081362 | DOI:10.1111/aor.70028

J Surg Case Rep. 2025 Oct 14;2025(10):rjaf812. doi: 10.1093/jscr/rjaf812. eCollection 2025 Oct.

ABSTRACT

Primary cardiac tumours in infants are rare, mostly benign, but can cause life-threatening complications. We present a 2-month-old female with respiratory distress, poor feeding, and prior pericardial effusion/cardiac arrest. Transthoracic echocardiography revealed a right atrial mass with massive pericardial effusion. Hemodynamic instability prompted urgent surgery. Intraoperatively, the tumour infiltrated the right atrial anterior wall and atrioventricular groove; subtotal resection and atrial reconstruction using a bovine pericardial patch were performed. Histopathology confirmed benign capillary hemangioma (CD31/CD34 positive). The infant recovered well, remaining recurrence-free at one year. This case illustrates the severe potential of cardiac capillary hemangiomas in infants. Despite critical location and rapid progression, surgical debulking stabilized hemodynamics despite incomplete resection.

PMID:41103496 | PMC:PMC12526885 | DOI:10.1093/jscr/rjaf812

Ann Surg Oncol. 2025 Oct 23. doi: 10.1245/s10434-025-18627-5. Online ahead of print.

NO ABSTRACT

PMID:41128956 | DOI:10.1245/s10434-025-18627-5

Ann Surg Oncol. 2025 Oct 23. doi: 10.1245/s10434-025-18627-5. Online ahead of print.

NO ABSTRACT

PMID:41128956 | DOI:10.1245/s10434-025-18627-5

J Surg Case Rep. 2025 Oct 14;2025(10):rjaf812. doi: 10.1093/jscr/rjaf812. eCollection 2025 Oct.

ABSTRACT

Primary cardiac tumours in infants are rare, mostly benign, but can cause life-threatening complications. We present a 2-month-old female with respiratory distress, poor feeding, and prior pericardial effusion/cardiac arrest. Transthoracic echocardiography revealed a right atrial mass with massive pericardial effusion. Hemodynamic instability prompted urgent surgery. Intraoperatively, the tumour infiltrated the right atrial anterior wall and atrioventricular groove; subtotal resection and atrial reconstruction using a bovine pericardial patch were performed. Histopathology confirmed benign capillary hemangioma (CD31/CD34 positive). The infant recovered well, remaining recurrence-free at one year. This case illustrates the severe potential of cardiac capillary hemangiomas in infants. Despite critical location and rapid progression, surgical debulking stabilized hemodynamics despite incomplete resection.

PMID:41103496 | PMC:PMC12526885 | DOI:10.1093/jscr/rjaf812

JACC Case Rep. 2025 Nov 22:106133. doi: 10.1016/j.jaccas.2025.106133. Online ahead of print.

ABSTRACT

BACKGROUND: Redo aortic and mitral valve surgery with severe mitral annular calcification (MAC) and intervalvular fibrous body destruction is highly challenging; the Commando procedure is often a last resort.

CASE SUMMARY: A 59-year-old man with prior mechanical aortic and mitral valve replacements presented with hemolytic anemia due to a mitral paravalvular leak. Imaging showed severe MAC and tricuspid regurgitation. Intraoperatively, massive calcification and insufficient native tissue precluded standard anchoring for implantation of the new mechanical valves. In addition to the standard Commando procedure, a bovine pericardial patch was used reconstruct a neo-mitral annulus. Recovery was uneventful.

DISCUSSION: Bovine pericardial patches offer structural support when native tissue is inadequate, facilitating safe and durable outcomes in complex redo valve procedures.

TAKE-HOME MESSAGES: This case illustrates a viable surgical strategy for high-risk redo double-valve procedures. Bovine patch reconstruction enabled stable valve implantation and functional restoration in the setting of extensive MAC.

PMID:41273326 | DOI:10.1016/j.jaccas.2025.106133

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