Esophageal cancer represents a significant public health concern; however, reliable diagnostic and prognostic markers have not been established. This study aimed to investigate the clinical value of plasma D-d… Read More
Category: General
Tissue requirements for the application of aortic valve neocuspidization – appropriate pericardium properties and homogeneity?
J Mater Sci Mater Med. 2024 Apr 29;35(1):26. doi: 10.1007/s10856-024-06790-2.
ABSTRACT
OBJECTIVE: Aortic valve neocuspidization (AVNeo) using autologous pericardium is a promising technique. Expected advantages are reduced immune response, appropriate biomechanics and lower treatment expenses. Nevertheless, autologous pericardium can be affected by patient’s age and comorbidities. Usually, glutaraldehyde (GA) – fixed bovine pericardium is the basic material for aortic valve prostheses, easy available and carefully pre-examined in a standardized fabrication process. Aim of the study is the verification of autologous pericardial tissue homogeneity by analysing tissue thickness, biomechanics and extracellular matrix (ECM) composition.
METHODS: Segments of human GA-fixed pericardium selected by the surgeon based on visual criteria for cusp pre-cut and remaining after surgical AV replacement were investigated in comparison to bovine standard tissue treated equivalently. Pericardium sampling was performed at up to three positions of each sutured cusp for histological or biomechanical analysis, according to tissue availability.
RESULTS AND CONCLUSIONS: Human pericardia exhibited a higher heterogeneity in collagen content, density of vessel structures and elastic moduli. Thickness, vessel density and collagen and elastin content differed significantly between the species. In contrast, significant interindividual differences were detected in most properties investigated for human pericardial samples but only for tissue thickness in bovine tissues. Higher heterogeneity of human pericardium, differing vessel and collagen content compared to bovine state-of-the-art material might be detrimental for long term AV functionality or deterioration and have to be intensely investigated in patients follow up after autologous cusp replacement.
PMID:38683259 | PMC:PMC11058761 | DOI:10.1007/s10856-024-06790-2
Treatment of chronic mini-thoracotomy wound pain and lung herniation with intercostal cryoablation and surgical mesh repair: a case report
The incidence of minimally invasive heart surgery via mini-thoracotomy (MT; right anterior thoracotomy) is on the rise, accompanied by an increase in post-MT intercostal nerve neuralgia and the risk of lung he… Read More
Thirty-three-year follow-up of pseudoaneurysm of the mitral-aortic intervalvular fibrosa without surgical treatment: a case report and literature review
Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (PMAIF) is a rare complication of infective endocarditis or aortic valve surgery. Surgical treatment is suggested, but the long-term follow-up of conse… Read More
Influence of ABC stroke score on late recurrence of paroxysmal atrial fibrillation following radiofrequency catheter ablation
In this study we investigated the impact of ABC stroke score on the recurrence of paroxysmal atrial fibrillation (PAF) following radiofrequency catheter ablation (RFCA).
Echocardiographic features of a giant aneurysm of membranous ventricular septum
We describe the echocardiographic features of a 22-year-old female with a giant aneurysm of membranous ventricular septum (AMVS). Both transthoracic echocardiography (TTE) and transesophageal echocardiography … Read More
Aortic arch de-branching for suspected expanding perigraft haematoma after previous acute type-A dissection repair with AMDS stent: a technique for a potential future problem
Acute Stanford type- A aortic dissections make up a large part of emergency cardiac surgery. They also carry a significant burden of morbidity. New techniques to aid aortic remodelling include the Ascyrus Medi… Read More
Sex-based disparities in ascending aortic aneurysm surgery outcomes: a comprehensive analysis of 1148 consecutive patients with propensity-score matching
Women undergoing cardiac surgery have been historically recognized to carry higher periprocedural mortality risk. We aimed to investigate the influence of sex on clinical presentation, perioperative, and long-… Read More
Transcatheter mitral valve-in-valve for pregnancy with anti-phospholipid syndrome: a case report
Perioperative management and cardiac surgery in pregnant women with anti-phospholipid syndrome combined with heart valve disease have been rarely reported.
Double patch repair for complete atrioventricular septal defect using the Invengenx® patch
Complete congenital Atrio-Ventricular (AV) septal defect repair is a complex technique and can be performed as a single patch, modified single patch or a double patch technique. In addition, reconstructive surgeries make it more challenging as the native pericardium available for the repair is limited and of poor quality. Thus, the use of engineered bovine pericardium can help in the reconstruction of large AV canal defects. We used the Invengenx® patch for the repair of a complete AV canal defect and Pulmonary Artery (PA) plasty in a 20 month old female child with a previous PA banding. The patch had good flexibility, mechanical strength, suturability and there were no complications such as thrombosis or infection on follow up.
Reconstructive surgery in congenital cardiac anomalies is fraught with challenges due to surgical complexities and the limited availability of native pericardium for performing the repair of large defects. We used the Invengenx® bovine pericardial tissue patch for the repair of a complete AVSD (post-pulmonary artery banding) and found the patch to be suitable for the re-do procedure and noted uniform thickness, good flexibility, mechanical strength, suture retention and no infection or thrombosis.