Category: General

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

Multimed Man Cardiothorac Surg. 2025 Sep 22;2025. doi: 10.1510/mmcts.2025.081.

ABSTRACT

Our objective is to underline that patients with small aortic annulus can present with concomitant left outflow tract obstruction, and both pathologies need to be addressed during surgery to avoid residual symptoms and early re-intervention. We present a third-time re-operation where intra-operative findings revealed degenerated sutureless valve with pannus underneath, which was explanted after meticulous dissection of the prosthesis cuff from the left ventricular outflow tract. The fibrotic ridge was excised and a basal septal myectomy was performed, removing 2.8 g of septal muscle. The aortotomy was extended through the left-non coronary commissure and toward the right and left fibrous trigones. A posterior bovine pericardium ‘Y’ patch was used for annular enlargement to accommodate a 25 mm INSPIRIS valve. Nonetheless, the mitral valve was repaired with a 29 mm posterior annuloplasty ring, and the tricuspid valve with a 30 mm annuloplasty ring.

PMID:40985399 | DOI:10.1510/mmcts.2025.081

Arch Peru Cardiol Cir Cardiovasc. 2025 Sep 24;6(3):181-185. doi: 10.47487/apcyccv.v6i3.498. eCollection 2025 Jul-Sep.

ABSTRACT

Aortic arch hypoplasia associated with ventricular septal defect (VSD) is a life-threatening congenital condition that demands early intervention. In low-resource settings, the lack of advanced tools complicates the safe use of selective antegrade cerebral perfusion (SACP) and innovative repair techniques such as interdigitating patch reconstruction. We describe the case of a newborn with severe aortic arch hypoplasia and a large perimembranous VSD who underwent successful one-stage surgical correction. The repair included aortic arch reconstruction using an interdigitating bovine pericardial patch and VSD closure under SACP delivered via direct brachiocephalic trunk cannulation. Despite the challenges of limited monitoring and equipment, the infant had an excellent clinical outcome. This case highlights the feasibility of adapting high-complexity cardiac techniques in resource-limited environments when surgical fundamentals and teamwork are prioritized. With strategic planning, multidisciplinary coordination, and adherence to evidence-based principles, successful single-stage repair of complex congenital heart disease is achievable even in under-resourced settings.

PMID:41262635 | PMC:PMC12624446 | DOI:10.47487/apcyccv.v6i3.498

Arch Peru Cardiol Cir Cardiovasc. 2025 Sep 24;6(3):170-175. doi: 10.47487/apcyccv.v6i3.499. eCollection 2025 Jul-Sep.

ABSTRACT

Clinical case of an 86-year-old male patient presenting with a late anterior myocardial infarction without reperfusion is reported. Initial echocardiographic assessment revealed a rare and complex mechanical complication: intramyocardial dissection of the left ventricular apex associated with interventricular septal rupture. Given the severity of the condition, an urgent surgical intervention was undertaken using a bovine pericardial patch. Although the initial postoperative course was favourable, multiple subsequent complications ultimately led to the patient’s death from ventricular arrhythmia on day 50th of hospitalisation. This report underscores the importance of timely diagnosis and multidisciplinary management of this rare clinical entity.

PMID:41262631 | PMC:PMC12624472 | DOI:10.47487/apcyccv.v6i3.499