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

JTCVS Tech. 2025 Sep 19;34:95-99. doi: 10.1016/j.xjtc.2025.08.027. eCollection 2025 Dec.

ABSTRACT

OBJECTIVE: We report the results of assessment of the Normo valve and the Normo operation using bioengineering methods.

METHODS: The Normo valve, made from bovine pericardium using a specially designed template and the flexible ring (27-mm Duran; Medtronic Inc), was installed into the pulsatile circulatory simulator. A 27-mm bioprosthetic valve (Mosaic; Medtronic Inc) was used as a control. The hydrodynamic performance of the Normo valve and bioprosthesis was investigated and compared. To assess the original template design, we created modified templates with slight alterations for both leaflets. The 4 types of valve made using these modified templates were tested to evaluate their hydrodynamic performance relative to the original design. In addition, finite element analysis was conducted to evaluate the relationship between leaflet stress and the distance between 2 major papillary muscles with the distances set at 18 mm, 24 mm, 30 mm, and 36 mm.

RESULTS: The waveforms of the Normo valve and bioprosthesis showed a similar pattern. As for the large leaflet, the Normo valve made from original design template revealed lowest pressure gradient compared to other 2 types. As for the small leaflet, the Normo valve made from original design template showed lowest pressure gradient with greatest forward flow. The stress on the leaflet increased for the distance between 2 papillary muscles at 18 mm and 36 mm.

CONCLUSIONS: The data obtained from the bioengineering method confirm the validity of the Normo valve’s design. Furthermore, the results show preferable positioning for the fixation of the leg to 2 papillary muscles.

PMID:41368376 | PMC:PMC12683050 | DOI:10.1016/j.xjtc.2025.08.027

Colloids Surf B Biointerfaces. 2026 Feb;258:115210. doi: 10.1016/j.colsurfb.2025.115210. Epub 2025 Oct 18.

ABSTRACT

The present study explores the development and characterization of a thermosensitive composite hydrogel derived from decellularized bovine pericardium (DPC) and MXene nanosheets intended for myocardial repair applications. The hydrogels were prepared by integrating Ti₃C₂T_x MXene nanosheets into the DPC matrix, resulting in thermosensitive composite gels with varying MXene concentrations (0.1-0.8 %). Their properties were assessed in terms of the gelation kinetics, mechanical strength, conductivity, and biocompatibility. Our findings indicate that the incorporation of MXene significantly enhanced the storage modulus of the hydrogels, reduced the gelation time, and preserved the structural integrity. Electrical conductivity increased with MXene concentration, with DPC-0.8 %M achieving conductivity levels closely resembling those of the native myocardial tissue. In vitro biocompatibility evaluation using H9c2 cardiomyocytes demonstrated that MXene-containing DPC hydrogels supported high cell viability and promoted cell proliferation without significant toxicity. Intramyocardial injection of the DPC-0.8 %M hydrogel into the infarcted region of rats with myocardial infarction resulted in a notable improvement in cardiac function, significant thickening of the ventricular wall, and considerable enhancement in myocardial regeneration. These findings underscore the potential of DPC-0.8 %M hydrogels to augment myocardial repair by providing mechanical support, facilitating electrical conductivity, and supporting cellular survival, thereby offering a promising strategy for cardiac tissue engineering and repair following myocardial infarction.

PMID:41129948 | DOI:10.1016/j.colsurfb.2025.115210

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