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Objective: Pericardial patches are commonly used in vascular surgery to close arteriotomies. The mechanism of early healing after patch implantation is still not well defined. We used a rat aortic patch model to assess pericardial patch healing and examined Ephrin-B2, a marker of arterial identity, expression within the post-implantation patch. We also determined whether endothelial progenitor cells (EPC) are associated with early patch healing in the arterial environment.
Methods: Wistar rats (200-250 grams) underwent infrarenal aortic arteriotomy and then closure via bovine or porcine pericardial patch angioplasty. Control groups included subcutaneously implanted patches. Patches were harvested at 0-30 days and analyzed by histology, immunohistochemistry, immunofluorescence and Western blot as well as quantitative PCR.
Results: Prior to implantation, pericardial patches are largely composed of collagen and are acellular. Following arterial implantation, increasing numbers of CD68-positive cells as well as Ephrin-B2 and CD34 dual-positive cells are found within both bovine and porcine pericardial patches, whereas the infiltrating cells are negative for vWF and α-actin. Porcine patches have a luminal monolayer of cells at day 7, compared to bovine patches that have fewer luminal cells. Subcutaneously implanted patches do not attract Ephrin-B2/CD34-positive cells. By day 30, both bovine and porcine pericardial patches develop a neointima that contains Ephrin-B2, CD34, and VEGFR2-positive cells.
Conclusion: Both CD68-positive and Ephrin-B2 and CD34 dual-positive cells infiltrate the pericardial patch early after implantation. Arteriotomy closure via pericardial patch angioplasty shows patch adaptation to the arterial environment that may involve a foreign body response as well as localization of EPC. Arterial remodeling of pericardial patches support endothelialization and may represent a paradigm of healing of scaffolds used for tissue engineering.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374760 | PMC |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0038844 | PLOS |
Khirurgiia (Mosk)
September 2025
Kursk State Medical University, Kursk, Russia.
Objective: To compare 6- and 12-month results of femoral artery repair with xenopericardial and autologous venous patch in hybrid treatment of critical lower limb ischemia.
Material And Methods: A retrospective analysis included 60 patients with critical lower limb ischemia who underwent hybrid treatment (balloon angioplasty and stenting of iliac arteries and open reconstruction of femoral arteries). Patients were divided into 2 groups by 30 people depending on femoral artery repair (group 1 - autologous venous patch, group 2 - xenopericardial patch).
Multimed Man Cardiothorac Surg
September 2025
Department of Cardiothoracic Surgery, Royal Children’s Hospital, Melbourne, Australia
The patient had rheumatic heart disease, which resulted in severe aortic and mitral valve regurgitation. Repair of both valves was performed at 9 years of age. During surgery, the retracted aortic valve cusps required extension with bovine pericardial patches and suture reduction annuloplasty, and the mitral valve was repaired using a Cosgrove-Edwards (Edwards Lifesciences LLC, Irvine, CA) annuloplasty band.
View Article and Find Full Text PDFSurg Case Rep
August 2025
Department of Cardiac and Vascular Surgery, Dokkyo Medical University School of Medicine, Shimotsugagun, Tochigi, Japan.
Introduction: Prosthetic valve endocarditis following aortic root replacement (ARR) typically necessitates redo-ARR, which involves complete graft removal, extensive aortic root dissection, and coronary reimplantation. This highly invasive procedure carries substantial surgical risk, including high operative mortality. In select high-risk patients without evidence of prosthetic graft infection, alternative surgical strategies may reduce procedural complexity and improve outcomes.
View Article and Find Full Text PDFJACC Case Rep
September 2025
Cardiology Unit, Cardiovascular Department, Humanitas Gavazzeni, Bergamo, Italy.
Background: We present a multimodality imaging study of a rare case of postsurgical chronically evolved pseudoaneurysm with a possible rupture buffered by the huge thrombus.
Case Summary: A patient known for previous late presentation myocardial infarction complicated by shock and ventricular septal defect and treated with surgical repair and triple coronary artery bypass grafting, was directed to our hospital for severe mitral regurgitation. Computed tomography, cardiac magnetic resonance, and echocardiography, in a multimodality approach, revealed a huge postsurgical cardiac pseudoaneurysm, with an extensive thrombus and the native pericardium not perfectly distinguishable from pseudoaneurysm tissue or surgical patch.
Gen Thorac Cardiovasc Surg Cases
September 2025
Department of Cardiovascular Surgery, Yuai Medical Center, Yone 50-5, Tomigusuku, Okinawa, Japan.
Background: The Commando procedure, which involves replacement of both the aortic and mitral valves along with reconstruction of the intervalvular fibrous body, is technically demanding. Commando procedure typically performed via an incision extending from the ascending aorta to the roof of the left atrium. However, in patients with extensive adhesions due to prior cardiac surgery, adding a superior transseptal incision can provide good exposure and reduce the risk of surrounding tissue injury.
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