A 72-year-old man presented with intermittent claudication and a foot ulcer. Computed tomography revealed severe calcification and occlusion of the left femoral artery and calcification and stenosis from the superficial femoral artery to the popliteal artery. Thromboendarterectomy (TEA) and anterior reconstruction of the femoral artery with a bovine pericardium patch were performed. We sutured the great saphenous vein on the bovine pericardium patch for bypass inflow after creating an anastomosis hole with a puncher and performed an in situ femorotibial bypass. This technique helped us achieve a smooth and clean anastomosis. In situ vein graft anastomosis might be difficult on severely atherosclerotic femoral artery after TEA and difficult anastomosis increases the risk of bypass occlusion. Anastomosis on the bovine pericardium patch for bypass inflow might ensure smooth and clean anastomosis in patients with severe atherosclerosis of the femoral artery.

There is a paucity of research investigating revision surgery for patients with previous inferior vena cava (IVC) reconstruction using bovine pericardium (BP). To the best of our knowledge, no reports of redo procedures have been published in the medical literature. We describe two cases of redo surgery in patients with previous IVC reconstructions using BP following disease recurrence. The first case underwent resection of the BP graft with a second IVC reconstruction using BP, the second case underwent resection of the BP graft without reconstruction due to extensive thromboses. Neither case experienced perioperative complication or morbidity following their redo procedure, and previous IVC reconstruction with BP did not present significant intraoperative technical challenges. One case showed evidence of endothelialisation of the excised BP graft, however, it was not possible to definitively conclude if endothelialisation was present in the second case. Overall, these cases demonstrate that previous IVC reconstruction using BP should not be considered an absolute contraindication for redo surgery in the context of disease recurrence.

BACKGROUND: Large esophageal perforations are challenging and often treated with exclusion or resection. This case demonstrates the feasibility of definitive surgical repair of a large esophageal perforation using large bovine pericardial patch.
METHODS: A patient with missed Boerhaave Syndrome underwent transesophageal echocardiography causing worsening perforation and sepsis. At thoracotomy and faced with a large esophageal defect, a large Bovine pericardial patch was used for repair with omentopexy. The patient recovered promptly and at 8 months was asymptomatic with satisfactory studies.
CONCLUSIONS: Xenograft pericardium is available and widely used for vascular reconstructions. It\'s use for primary repair of large esophageal perforations should be considered.

•Bovine pericardium for IVC reconstruction has significant advantages comparing to vascular ligation, autogenous or PTFE grafts.•En-bloc resection of metastatic precaval lymph nodes and reconstruction of the IVC is feasible.•Recurrence of endometrial cancer at para-aortic lymph nodes is good candidate for secondary cytoreduction with MDT approach.

BACKGROUND: The most common mechanism of aortic injury involves motor vehicle collisions resulting in aortic disruptions, occurring almost exclusively in the chest. Injury to the abdominal aorta following blunt trauma is nearly twenty times less likely to occur than the thoracic aorta. Because of the low incidence, there are few reports regarding the presentation and repair of these particular injuries, especially in the pediatric population.
METHODS: We present a case of a 7-year-old boy involved in a high speed motor vehicle accident with an abdominal aorta transection at the aortic bifurcation extending into the left iliac artery. The injury was repaired using bovine pericardium with the adventitia and intima of the vessel approximated over the bovine bridge.
CONCLUSIONS: Primary repair of thoracic aortic injury has been thoroughly described in the literature with good outcomes yet, abdominal aortic repair remains ambiguous. Few techniques and materials have been described with even less data surrounding the long-term outcomes.
CONCLUSIONS: Bovine pericardium is a strong and stable acellular collagenous material with the potential to accelerate endothelialization and tissue regeneration. This remains an interesting field of research as stenosis and pseudo-coarction data have yet to be determined.