Biomechanical Evaluation of Stress–Strain Behavior of Different Bovine Pericardial Patches Preserved in Glutaraldehyde Solution

Abstract Background: Bovine pericardial patches (BPPs) preserved in glutaraldehyde are widely used in cardiovascular surgery due to their durability, biocompatibility, and availability, particularly in infected or contaminated fields. However, differences in harvesting site, animal age, and decellularization techniques may influence biomechanical behavior, which can change the outcome of surgical treatment. Stiffer grafts may impair aortic compliance and contribute to adverse cardiac remodeling. This study assessed the biomechanical properties of commonly used commercial BPPs, focusing on intra- and inter-sample variability and measuring the BPPs at different elastic modulus values. Methods: Forty BPPs from four suppliers ( n = 10 each) were analyzed. Each patch was sectioned into four bone-shaped specimens (two horizontal, two vertical) according to our laboratory’s standardized protocol. Thickness was measured at three points per specimen. Uniaxial tensile testing was performed under physiological conditions with preconditioning cycles using the LM1 system. Elastic modulus values were assessed at three physiological loading stages: physiological elastic modulus (PEM: 80–140 mmHg), maximum physiological elastic modulus (MPEM: 360 mmHg), and maximum elastic modulus (MEM: failure point). Variability was analyzed using paired comparisons and the coefficient of variation. Results: Thickness ranged from 0.384 to 0.469 mm, with low variability across suppliers. Orientation-related thickness differences were not significant for most samples. Supple Peri-Guard patches exhibited significantly lower PEM values than Xenosure ( p = 0.0035) and Invengenx ( p = 0.0396). No significant differences among suppliers were found for MPEM or MEM. Orientation did not significantly influence biomechanical performance. Coefficient of variation values confirmed minimal intra-sample variability. Conclusion: BPPs preserved in glutaraldehyde demonstrate consistent thickness and homogeneous elastic behavior across suppliers, supporting their safe and reliable use in cardiovascular reconstruction. Further histological and long-term in vivo studies are recommended to evaluate remodeling and potential hemodynamic effects.