{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:54:27Z","timestamp":1791201267804,"version":"4.2.0"},"reference-count":25,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Limited availability of pulmonary homografts may restrict right ventricular outflow tract reconstruction after the Ross procedure. This technical note describes the geometric construction of a valved conduit composed of autologous pericardial cusps and a tubularized bovine pericardial patch. Methods: Autologous pericardium (approximately 10 \u00d7 8 cm) is treated with 0.9% glutaraldehyde for 10 min, and three size-4 cusps with triangular ears are fashioned using a Fehling template. A bovine pericardial patch (14 \u00d7 9 cm) is marked with the cusp attachment baseline, the commissural fixation line, and asymmetric tubularization lines. The cusp implantation field is divided into three equal segments, and each cusp is sutured to the mesothelial surface of the patch with a continuous suture, followed by commissural fixation. The patch is then tubularized, and valve competence is assessed by saline testing. Results: The conduit was constructed in approximately 60 min, in parallel with the main operation, and implanted in four patients undergoing a modified Ross procedure in 2025. Echocardiography on the first postoperative day showed no more than trace pulmonary regurgitation and no conduit obstruction. No conduit-related complications occurred; only early postoperative follow-up is available. Conclusions: The technique allows construction of a valved conduit from autologous and bovine pericardium using widely available materials. Currently, it demonstrates technical feasibility only; hemodynamic performance, safety, and durability remain to be established in larger studies with standardized follow-up.<\/jats:p>","DOI":"10.3390\/jcm15197684","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:57:46Z","timestamp":1791197866000},"page":"7684","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Autologous Pericardial Cusps Within a Tubularized Bovine Pericardial Conduit for Right Ventricular Outflow Tract Reconstruction During the Modified Ross Procedure: A Technical Note"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4195-5180","authenticated-orcid":false,"given":"Tom\u00e1\u0161","family":"Toporcer","sequence":"first","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute of Cardiovascular Diseases and Medical Faculty, Pavol Jozef \u0160af\u00e1rik University, 04011 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luk\u00e1\u0161","family":"Vajda","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute of Cardiovascular Diseases and Medical Faculty, Pavol Jozef \u0160af\u00e1rik University, 04011 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Bere\u0161","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute of Cardiovascular Diseases and Medical Faculty, Pavol Jozef \u0160af\u00e1rik University, 04011 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaroslav","family":"Bened\u00edk","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Na Homolce Hospital, 15030 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari\u00e1n","family":"Homola","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute of Cardiovascular Diseases and Medical Faculty, Pavol Jozef \u0160af\u00e1rik University, 04011 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9607-5949","authenticated-orcid":false,"given":"Michal","family":"Trebi\u0161ovsk\u00fd","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute of Cardiovascular Diseases and Medical Faculty, Pavol Jozef \u0160af\u00e1rik University, 04011 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"\u0160af\u00e1r","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute of Cardiovascular Diseases and Medical Faculty, Pavol Jozef \u0160af\u00e1rik University, 04011 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0160tefan","family":"Luka\u010d\u00edn","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute of Cardiovascular Diseases and Medical Faculty, Pavol Jozef \u0160af\u00e1rik University, 04011 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vil\u00e9m","family":"Rohn","sequence":"additional","affiliation":[{"name":"I. Surgery Department\u2014Cardiovascular Surgery, General University Hospital and Second Faculty of Medicine, Charles University, 12808 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9390-7191","authenticated-orcid":false,"given":"Adri\u00e1n","family":"Koles\u00e1r","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, East Slovak Institute of Cardiovascular Diseases and Medical Faculty, Pavol Jozef \u0160af\u00e1rik University, 04011 Ko\u0161ice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Toporcer, T., Lukacin, S., Kraus, A., Homola, M., Beres, A., Trebisovsky, M., Radotzy, D., Rohn, V., and Kolesar, A. (2025). Bioprostheses and Mechanical Prostheses for Aortic Valve Replacement in Patients Aged 50 to 65 Years Offer Similar Long-Term Survival Rates. J. Cardiovasc. Dev. Dis., 12.","DOI":"10.3390\/jcdd12020044"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"ytaf291","DOI":"10.1093\/ehjcr\/ytaf291","article-title":"Pulmonary valve neo-reconstruction using the Ozaki technique in an adapted Ross procedure: Case report","volume":"9","author":"Kolesar","year":"2025","journal-title":"Eur. Heart J. Case Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"ezaf295","DOI":"10.1093\/ejcts\/ezaf295","article-title":"EACTS Expert Consensus Statement on the Ross Procedure in Adult Patients","volume":"68","author":"Vojacek","year":"2026","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1510\/icvts.2010.253682","article-title":"Aortic valve reconstruction using self-developed aortic valve plasty system in aortic valve disease","volume":"12","author":"Ozaki","year":"2011","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.athoracsur.2023.12.010","article-title":"Midterm Outcomes After Aortic Valve Neocuspidization (Ozaki Procedure) in Adults","volume":"117","author":"Ogami","year":"2024","journal-title":"Ann. Thorac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"102156","DOI":"10.1016\/j.jacadv.2025.102156","article-title":"Mid-Term Experience With 1,196 Ozaki Procedures","volume":"4","author":"Ozaki","year":"2025","journal-title":"JACC Adv."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1053\/j.optechstcvs.2024.07.004","article-title":"Modified Aortic Valve Neocuspidization (Ozaki AVNeo) Procedure","volume":"29","author":"Bourgan","year":"2024","journal-title":"Oper. Tech. Thorac. Cardiovasc. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1053\/j.semtcvs.2022.01.006","article-title":"Surgical Valve Choices for Pulmonary Valve Replacement","volume":"35","author":"Kwon","year":"2023","journal-title":"Semin. Thorac. Cardiovasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1016\/j.athoracsur.2019.05.068","article-title":"Outcomes of Bioprosthetic Valves in the Pulmonary Position in Adults With Congenital Heart Disease","volume":"108","author":"Egbe","year":"2019","journal-title":"Ann. Thorac. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1053\/j.semtcvs.2020.05.026","article-title":"Durability of the St. Jude Epic Supra Bioprosthetic Valve in the Pulmonary Position","volume":"33","author":"Spigel","year":"2021","journal-title":"Semin. Thorac. Cardiovasc. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1016\/j.jtcvs.2017.04.072","article-title":"Mechanical valves in the pulmonary position: An international retrospective analysis","volume":"154","author":"Pragt","year":"2017","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1093\/ejcts\/ezaa345","article-title":"Pulmonary valve reconstruction using Ozaki\u2019s technique for infective endocarditis","volume":"59","author":"Yepez","year":"2021","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5630","DOI":"10.1111\/jocs.17172","article-title":"Pulmonary artery sarcoma treated with pulmonary endarterectomy and leaflet reconstruction using Ozaki technique","volume":"37","author":"Arslanhan","year":"2022","journal-title":"J. Card. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1007\/s12055-022-01469-1","article-title":"Trileaflet pulmonary valve reconstruction with the Ozaki technique in an adult patient of tetralogy of Fallot with absent pulmonary valve","volume":"39","author":"Singh","year":"2023","journal-title":"Indian J. Thorac. Cardiovasc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"618","DOI":"10.21470\/1678-9741-2019-0329","article-title":"The Russian Conduit\u2014Combining Bentall and Ozaki Procedures for Concomitant Ascending Aorta Replacement and Aortic Valve Neocuspidization","volume":"34","author":"Komarov","year":"2019","journal-title":"Braz. J. Cardiovasc. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/S1010-7940(00)00500-5","article-title":"Eight years clinical experience with the replacement of the ascending aorta using composite xenopericardial conduit","volume":"18","author":"Malashenkov","year":"2000","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"i3","DOI":"10.1093\/ejechocard\/jen243","article-title":"Structure and anatomy of the aortic root","volume":"10","author":"Ho","year":"2009","journal-title":"Eur. J. Echocardiogr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/S0022-5223(00)70200-5","article-title":"Method of determination of aortic valve parameters for its reconstruction with autopericardium: An experimental study","volume":"119","author":"Gasparyan","year":"2000","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S0022-5223(95)70248-2","article-title":"Aortic valve replacement with freehand autologous pericardium","volume":"110","author":"Duran","year":"1995","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e509","DOI":"10.1016\/j.athoracsur.2020.03.125","article-title":"Surgical Valve Repair of Native Pulmonary Valve Endocarditis Using the Ozaki Technique","volume":"110","author":"Jaswal","year":"2020","journal-title":"Ann. Thorac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"107457","DOI":"10.1016\/j.carpath.2022.107457","article-title":"The influence of glutaraldehyde on the microscopic structure of human pericardium","volume":"61","author":"Poppenborg","year":"2022","journal-title":"Cardiovasc. Pathol."},{"key":"ref_22","first-page":"402","article-title":"Effects of glutaraldehyde concentration and fixation time on material characteristics and calcification of bovine pericardium: Implications for the optimal method of fixation of autologous pericardium used for cardiovascular surgery","volume":"24","author":"Lee","year":"2017","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"21","DOI":"10.37190\/ABB-02119-2022-01","article-title":"Mechanical properties of the porcine pericardium extracellular matrix cross-linked with glutaraldehyde and tannic acid","volume":"24","author":"Dabrowska","year":"2022","journal-title":"Acta Bioeng. Biomech."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1002\/jbm.820180703","article-title":"Toxic reactions evoked by glutaraldehyde-fixed pericardium and cardiac valve tissue bioprosthesis","volume":"18","author":"Gendler","year":"1984","journal-title":"J. Biomed. Mater. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.athoracsur.2004.06.033","article-title":"Calcification of tissue heart valve substitutes: Progress toward understanding and prevention","volume":"79","author":"Schoen","year":"2005","journal-title":"Ann. Thorac. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7684\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:11:51Z","timestamp":1791198711000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7684"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,4]]},"references-count":25,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["jcm15197684"],"URL":"https:\/\/doi.org\/10.3390\/jcm15197684","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,4]]}}}