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Congenital aortic valve repair using CorMatrix® : A histologic evaluation
Michael Hofmann1, Martin O Schmiady1, Barbara E Burkhardt2
1Division of Congenital Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland.
Xenotransplantation
|September 24, 2017
Summary
Decellularized extracellular matrix (dECM) for pediatric aortic valve repair showed initial mechanical success but led to significant valve insufficiency due to chronic inflammation and lack of proper remodeling.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Pediatric Cardiology
Background:
- Heart valve reconstruction offers significant benefits, especially for pediatric patients.
- Decellularized extracellular matrix (dECM), specifically CorMatrix®, was utilized for aortic valve procedures.
Purpose of the Study:
- To evaluate the use of dECM in pediatric aortic valve repair and reconstruction.
- To assess the histological and functional outcomes of dECM implantation in young patients.
Main Methods:
- Retrospective review of 6 pediatric patients (2 months - 14 years) undergoing aortic valve repair with dECM.
- dECM used for leaflet replacement or extension in cases of stenosis or regurgitation.
- Echocardiographic follow-up, with reoperation and histological/immunohistochemical examination of explanted dECM in 4 cases.
Main Results:
- Early postoperative period was uneventful with scaffold fulfilling mechanical needs.
- Significant valve insufficiency developed in 5 patients between 119-441 days postoperatively.
- Explanted dECM showed inflammatory cell migration, leading to structural/functional changes from chronic inflammation.
Conclusions:
- Implantation of dECM resulted in a mixed immunological response of remodeling and inflammation.
- The anticipated cellular infiltration, remodeling, and development of a 3-layered architecture were not observed in explanted specimens.
