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Is Porcine Small Intestinal Submucosal Extracellular Matrix (ECM) a Suitable Material for Right Ventricular Outflow
Christopher R Burke1, Erik Lewis1, Nicholas A Schreiter2
17284University of Washington, Seattle, WA, USA.
World Journal for Pediatric & Congenital Heart Surgery
|January 5, 2022
Summary
Extracellular matrix (ECM) patches used in pulmonary valve replacement (PVR) with right ventricular outflow tract (RVOT) reconstruction may lead to dehiscence and paravalvular leaks. These findings suggest avoiding ECM in RVOT reconstruction for PVR patients.
Area of Science:
- Congenital heart surgery
- Biomaterials in cardiac repair
- Cardiovascular surgery outcomes
Background:
- Pulmonary valve replacement (PVR) with right ventricular outflow tract (RVOT) reconstruction is a frequent procedure for congenital heart defects.
- Extracellular matrix (ECM) derived from porcine submucosal intestine has been employed for RVOT reconstruction.
Purpose of the Study:
- To report on two adult cases of Tetralogy of Fallot undergoing PVR with ECM-based RVOT reconstruction.
- To evaluate the safety and efficacy of ECM patches in this specific surgical context.
Main Methods:
- Case report of two adult patients with Tetralogy of Fallot.
- Utilized porcine submucosal intestinal-derived ECM for RVOT reconstruction during PVR.
- Follow-up assessment for complications related to the ECM patch.
Main Results:
- Both patients required reoperation due to patch dehiscence.
- Significant paravalvular leaks were identified as a consequence of ECM dehiscence.
- One patient developed a pseudoaneurysm secondary to the ECM patch failure.
Conclusions:
- There appears to be a risk of ECM patch dehiscence when used for RVOT reconstruction in PVR.
- Avoidance of ECM in this specific application is recommended based on these cases.
- Patients who have undergone PVR with ECM repair should be closely monitored for potential dehiscence complications.
