{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:04:14Z","timestamp":1770743054974,"version":"3.49.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Stiftung zur F\u00f6rderung der herzchirurgischen Forschung am Inselspital Bern, the F\u00f6rderverein Deutsches Herzzentrum M\u00fcnchen, and the Deutsche Herzstiftung"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Currently available materials in congenital cardiac surgery (CCS) are far from optimal because they do not facilitate growth, remodelling, or renewal, resulting in poorer long-term outcomes due to material-related limitations. Bacterial cellulose (BC), a biogenic polymer-based material produced by Acetobacter xylinum, has emerged as a promising alternative exhibiting excellent bio- and haemocompatibility. This study aimed to develop BC specifically for application in CCS by modifying culturing conditions to enhance its biomechanical resilience.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Bacterial cellulose was produced according to a standard protocol, and its biomechanical properties were evaluated using inflation pressure testing, thickness measurement, and uniaxial tensile testing. To improve these characteristics, 2 modifications, a change in the growth media composition and an extended incubation time, were implemented and subsequently evaluated in 5 further test series. The long-term durability of BC patches was assessed in a fatigue tester for 20\u2009\u00b1\u20090.5 million cycles, and potential structural damage was investigated using scanning electron microscopy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Utilizing the 2 modifications, BC patches demonstrated a capability to reach and maintain pressures exceeding 1000 mm Hg with a durability of 100% (n\u2009=\u200924), compared to the standard 20.8% (n\u2009=\u200924) at 500 mm Hg. The maximum tensile strength was enhanced from 0.311\u2009\u00b1\u20090.057 megapascal (MPa) to 0.986\u2009\u00b1\u20090.397 MPa (P\u2009&amp;lt;\u2009.0001), with a thickness of 3.89\u2009\u00b1\u20090.95 mm (P\u2009&amp;lt;\u2009.0001). In the long-term durability testing, patches endured durations equalling 6 months without failure while retaining structural integrity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The potential of BC for use in CCS was demonstrated by enhancing its biomechanical properties through culturing modifications, warranting further investigation and development of the biomaterial.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf310","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T15:56:12Z","timestamp":1758642972000},"source":"Crossref","is-referenced-by-count":1,"title":["Biogenic Polymers for Congenital Cardiac Surgery: In Vitro Durability Testing"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9344-1821","authenticated-orcid":false,"given":"Julian","family":"Hubrich","sequence":"first","affiliation":[{"name":"Department of Congenital and Pediatric Cardiac Surgery, German Heart Center Munich, Technical University , Munich, 80636,","place":["Germany"]},{"name":"Division of Congenital and Pediatric Cardiac Surgery, LMU University Hospital , Munich, 81377,","place":["Germany"]},{"name":"Ekhz, European Kids Heart Center , Munich, 80636,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance , Munich, 80636,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Grefen","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance , Munich, 80636,","place":["Germany"]},{"name":"Department of Cardiac Surgery, LMU University Hospital, LMU Munich , Munich, 81377,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Zorin","sequence":"additional","affiliation":[{"name":"Division of Congenital and Pediatric Cardiac Surgery, LMU University Hospital , Munich, 81377,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Richert","sequence":"additional","affiliation":[{"name":"Division of Congenital and Pediatric Cardiac Surgery, LMU University Hospital , Munich, 81377,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, LMU University Hospital, LMU Munich , Munich, 81377,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silje","family":"Jahren","sequence":"additional","affiliation":[{"name":"ARTORG Center for Biomedical Engineering 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80636,","place":["Germany"]},{"name":"ARTORG Center for Biomedical Engineering Research, University of Bern , Bern, 3008,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"H\u00f6rer","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Cardiac Surgery, German Heart Center Munich, Technical University , Munich, 80636,","place":["Germany"]},{"name":"Division of Congenital and Pediatric Cardiac Surgery, LMU University Hospital , Munich, 81377,","place":["Germany"]},{"name":"Ekhz, European Kids Heart Center , Munich, 80636,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Herz","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance , Munich, 80636,","place":["Germany"]},{"name":"Department of Cardiac Surgery, LMU University Hospital, LMU Munich , Munich, 81377,","place":["Germany"]},{"name":"Chair of Medical Materials and Implants, Technical University , Munich, 85748,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Grab","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance , Munich, 80636,","place":["Germany"]},{"name":"Department of Cardiac Surgery, LMU University Hospital, LMU Munich , Munich, 81377,","place":["Germany"]},{"name":"Chair of Medical Materials and Implants, Technical University , Munich, 85748,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4061-4499","authenticated-orcid":false,"given":"Paul Philipp","family":"Heinisch","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Cardiac Surgery, German Heart Center Munich, Technical University , Munich, 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