Pulmonary artery augmentation using decellularized equine pericardium (Matrix Patch™): initial single-centre...

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Biomaterials Science

Background:

• Congenital heart defects often necessitate pulmonary artery reconstruction.
• Augmentation of branch pulmonary arteries (PAs) is crucial for improving outcomes in pediatric patients.
• Cell-free equine-derived pericardium patches offer a potential alternative to existing materials.

Purpose of the Study:

• To evaluate the initial clinical experience with Matrix Patch for branch pulmonary artery augmentation in pediatric patients.
• To assess the feasibility, safety, and early outcomes of using Matrix Patch in complex cardiac surgeries.
• To analyze explanted patches for signs of recellularization, inflammation, and calcification.

Main Methods:

• A retrospective analysis of 96 pediatric patients (median age 3.2 years) who underwent branch PA augmentation using Matrix Patch between 2016 and 2019.
• Implantation in 147 locations, predominantly in redo surgeries (89.6%).
• Primary endpoints included death or patch-related reoperation/stent implantation; explanted patches underwent histological analysis.

Main Results:

• Eighty-one patients were followed for a median of 20 months. No patch-related deaths occurred.
• Survival at last follow-up was 88%. Probability of freedom from reoperation/stent implantation at 12 and 24 months was 85.8% and 78.7%, respectively.
• Explanted patches showed superficial proliferation and macrophage activity, but no calcification.

Conclusions:

• Matrix Patch demonstrates comparable early results to other xenogeneic materials for branch PA augmentation in children.
• The observed tissue response suggests potential for integration, but long-term durability needs further investigation.
• Continued follow-up is essential to confirm the long-term efficacy and safety of Matrix Patch in pediatric cardiovascular surgery.