Early Degeneration of Extracellular Matrix Used for Aortic Reconstruction During the Norwood Operation

The use of prosthetic patch material is often required during the surgical reconstruction of complex congenital cardiac malformations. Decellularized porcine small intestinal submucosa, a type of extracellular matrix, was recently introduced as a patch for cardiac and vascular tissue repair. Extracellular matrix was used for aortic reconstruction during the Norwood procedure in 8 consecutive neonates with hypoplastic left heart syndrome. Rapid degeneration or aneurysm formation developed in 3 of these patients who came to second-stage surgery. Extracellular matrix should be used cautiously for aortic reconstruction in infants until additional reports from other centers provide confirmation of its safety.